US9402916B2 - Re-directed immunotherapy - Google Patents

Re-directed immunotherapy Download PDF

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Publication number
US9402916B2
US9402916B2 US14/005,452 US201214005452A US9402916B2 US 9402916 B2 US9402916 B2 US 9402916B2 US 201214005452 A US201214005452 A US 201214005452A US 9402916 B2 US9402916 B2 US 9402916B2
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peptidase
cells
cell
subfamily
seq
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US20140004081A1 (en
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Mark Cobbold
David Millar
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University of Birmingham
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University of Birmingham
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Priority claimed from GBGB1203434.4A external-priority patent/GB201203434D0/en
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    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
    • C07K16/30—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants from tumour cells
    • C07K16/3046—Stomach, Intestines
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
    • C07K16/30—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants from tumour cells
    • C07K16/3053—Skin, nerves, brain
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/20—Immunoglobulins specific features characterized by taxonomic origin
    • C07K2317/24—Immunoglobulins specific features characterized by taxonomic origin containing regions, domains or residues from different species, e.g. chimeric, humanized or veneered
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/60—Immunoglobulins specific features characterized by non-natural combinations of immunoglobulin fragments
    • C07K2317/62—Immunoglobulins specific features characterized by non-natural combinations of immunoglobulin fragments comprising only variable region components
    • C07K2317/622—Single chain antibody (scFv)
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2319/00—Fusion polypeptide
    • C07K2319/33—Fusion polypeptide fusions for targeting to specific cell types, e.g. tissue specific targeting, targeting of a bacterial subspecies
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2319/00—Fusion polypeptide
    • C07K2319/50—Fusion polypeptide containing protease site
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N2710/00—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA dsDNA viruses
    • C12N2710/00011—Details
    • C12N2710/16011—Herpesviridae
    • C12N2710/16111—Cytomegalovirus, e.g. human herpesvirus 5
    • C12N2710/16134—Use of virus or viral component as vaccine, e.g. live-attenuated or inactivated virus, VLP, viral protein

Definitions

  • the present invention relates to immunotherapeutic agents.
  • it relates to agents that can be used to prevent or treat a condition characterised by the presence of unwanted cells, such as tumours or other disease causing cells.
  • Immunotherapeutic strategies for targeting malignant disease are an active area of translational clinical research, and have been for several decades.
  • the current models dictate that cancer represents either a functional or constitutional immunodeficiency which can be treated with immunotherapeutic manipulation of the host.
  • These efforts can be broadly classified into 2 groups.
  • the first serves to augment or support endogenous anti-tumour immunity through measures such as vaccination, cytokine support (IL-2, IFN ⁇ ) or reducing immunosuppressant environment (ipilimumab) whilst the second seeks to restore an absolute deficiency with components of a functional immune response (passive immunotherapy with antibodies, TCR transfer, Stem Cell Transplantation and adoptive immunotherapy).
  • cytotoxic therapeutic antibodies rely on immunological effector mechanisms to deliver their anti-cancer effect such as complement dependent cytotoxicity (CDC) and Antibody Dependent Cellular Cytotoxicity (ADCC).
  • CDC complement dependent cytotoxicity
  • ADCC Antibody Dependent Cellular Cytotoxicity
  • all cells both healthy and malignant have numerous mechanisms to limit attack by the immune response to avert autoimmunity. This is evident in the context of autoimmune disease where high levels of tissue-reactive antibodies, which although frequently evoke organ inflammation, rarely induce complete organ destruction. Indeed, autoimmune diseases where complete tissue destruction is observed, such as diabetes mellitus, are known to be dependent on CTL responses rather than antibody-directed mechanisms.
  • ADCs antibody-drug conjugates
  • ADCs generally comprise a monoclonal antibody against a target present on a tumour cell, a cytotoxic drug, and a linker that attaches the antibody to the drug.
  • ADCs are currently in the late stage of clinical development, and of those that are, clinical success has proven elusive.
  • WO 95/17212 describes conjugates consisting of peptidic T cell antigens and cell binding partners and their use in re-directed immunotherapy.
  • the conjugates comprise a binding partner with selectivity for target cells and a T cell antigen, and are said to induce specific cytotoxicity of T cells in the treatment of cancer, autoimmune diseases, diabetes or allergic diseases.
  • the conjugates are said to be internalised into target cells following binding of the binding partner to surface receptors, and the T cell antigen is processed from the conjugate and expressed on the cell surface in the form of a complex with MHC molecules. Cytotoxicity of T cells for the target cells is thereby induced.
  • MHC Class-I pathway An advantage of the MHC Class-I pathway is that, unlike MHC Class-II molecules, MHC Class-I molecules are present on all cell types.
  • FIG. 1 MDA.MB.231 cells transduced with MMP14 stained with Cetuximab conjugated to NLVPMVATV (SEQ ID No: 21) containing MMP14 cleavage sequence (NLVPMVATVLPRSAKELRC (SEQ ID No: 280) linked to Cetuximab using Sulpho-SMCC).
  • NLVPMVATV SEQ ID No: 21
  • NLVPMVATVLPRSAKELRC SEQ ID No: 280
  • FIG. 2 B-LCL cells stained with Rituximab conjugated to the HLA class-II peptide DYSNTHSTRYV (SEQ ID No: 55) containing a protease cleavage sequence (DDYSNTHSTRYVTIPVSLRSGGGGSGGGGSC) (SEQ ID No: 274).
  • FIG. 3 B-LCL cells stained with Rituximab conjugated to the HLA class-I peptide TPRVTGGGAM (SEQ ID No: 31) containing a protease cleavage sequence (KTPRVTGGGAMAIPVSLRSGGGGSGGGGSC) (SEQ ID No: 273) linked to Rituximab using Sulpho-SMCC.
  • TPRVTGGGAM HLA class-I peptide
  • KTPRVTGGGAMAIPVSLRSGGGGSGGGGSC protease cleavage sequence linked to Rituximab using Sulpho-SMCC.
  • FIG. 4 (A) Schematic diagram of an exemplary embodiment of the invention. (B) Schematic showing design and mechanism of viral peptide delivery. (i) Preferred targeting molecule consisting of a monoclonal antibody able to target a tumour cell, covalently linked to a synthetic peptide containing a protease recognition domain and a T cell peptide antigen. (ii) The peptide-conjugate is delivered to the target cell via a specific antibody and the peptide is cleaved in the proximity of the tumour cell. The released smaller viral peptide is passively binds to empty to empty MHC class I or II molecules on the cell surface. The MHC-peptide complexes are then recognised and by specific circulating T-cells mediating tumour cell-lysis.
  • Preferred targeting molecule consisting of a monoclonal antibody able to target a tumour cell, covalently linked to a synthetic peptide containing a protease recognition domain and a T cell peptide antigen.
  • FIG. 5 In vitro activity of redirected virus-specific T cells.
  • A Recognition of a lymphoblastoid lymphoma cell lines by CD8 + cytomegalovirus-specific cytotoxic T lymphocytes through conjugation of the cognate antigen TPRVTGGGAM (SEQ ID No: 31) peptide to Rituximab (anti-CD20). Recognition is only present if the peptide is flanked by the MMP2 cleavage motif. Controls are tumour cells alone, CTLs alone and tumour cells pulsed with free TPR peptide (KTPRVTGGGAMAIPVSLRSGGGGSGGGGSC) (SEQ ID No: 273) linked to Rituximab using Sulpho-SMCC.
  • TPRVTGGGAMAIPVSLRSGGGGSGGGGSC free TPR peptide
  • Tumour cells were then incubated overnight with DYSN-specific CD4 + T cells and T cell recognition determined using IFN ⁇ release by ELISA.
  • the inclusion of a protease cleavage site adjacent to the DYSN peptide dramatically increases recognition of the tumour cells by CD4 + T cells.
  • C Application toward breast carcinoma cell line MDA-MB231 using cytomegalovirus-specific CD8 + CTL specific for cytomegalovirus pp65 (NLVPMVATV) (SEQ ID No: 21) epitope.
  • Conjugation of the peptide combined with a MMP14 cleavage site mediates killing of the cells (NLVPMVATVLPRSAKELRC; SEQ ID No: 280) linked to Cetuximab using Sulpho-SMCC. Further data not shown indicates that a peptide conjugate lacking the MMP14 cleavage site shows killing comparable to Cetuximab alone.
  • FIG. 6 In vitro and in vivo targeting of tumour cell lines using APEC approach.
  • A EGFR expression on two breast carcinoma cell lines MCF7 and MB-MDA231.
  • B Successful targeting of EGFR+ cell line MDA-MB231 using NLVPMVATV (SEQ ID No: 21) peptide containing a protease cleavage site (CSGGGGSGGGGAIPVSLRANLVPMVATV; SEQ ID No: 276) conjugated to Cetuximab.
  • NLVPMVATV SEQ ID No: 21
  • CSGGGGSGGGGAIPVSLRANLVPMVATV SEQ ID No: 276
  • MCF-7 which does not express EGFR is not targeted by Cetuximab immunoconjugate.
  • the B-RPH is a HLA-mismatched peptide deigned to not be recognised by the T cells and the VLE-protease cleavage peptide is an HLA-matched peptide.
  • This peptide is designed to be a control for the protease cleavage sequence to ensure that the T cells do not recognise a portion of the protease cleavage sequence.
  • the response to the VLE-protease cleavage peptide is negligible, the response seen with the NLV-protease cleavage peptide is borne against the NLVPMVATV (SEQ ID No: 21) sequence and not the protease cleavage sequence.
  • FIG. 7 In vivo targeting of tumour cell lines using APEC approach.
  • A in vivo xenograft data demonstrating that the human MDA-MB-231 breast cancer cell line can be eradicated by CMV-specific T cells when Cetuximab-peptide conjugates are given via intraperitoneal injection. Cetuximab-peptide complexes alone are unable to control the tumour growth (upper), whilst neither are CMV-specific T-cells (middle). However the combination of both cause eradication of this aggressive breast cancer tumour in vivo.
  • B Successful targeting of colorectal cell line Colo205 using anti-Muc1 antibodies linked with CMV-specific T cell epitope and protease cleavage site.
  • GP1.4 and SM3 are well-characterised anti-MUC1 specific antibodies.
  • This anti-Muc1 antibody-peptide conjugate also very efficiently targets pancreatic carcinoma cell line Panc1.
  • MH1, SM3 and GP1.4 are all well-characterised MUC1-specific monoclonal antibodies.
  • MH1 is specific for the cytoplasmic tail of MUC1 and therefore does not bind to intact tumour cells, whereas, SM3 and GP1.4 bind to the extracellular portion of MUC1 glycoprotein.
  • the peptide used is the NLV peptide using the reverse sequence (CSGGGGSGGGGAIPVSLRANLVPMVATV) (SEQ ID No: 276).
  • the peptides are as follows NLVR (CSGGGGSGGGGAIPVSLRANLVPMVATV) (SEQ ID No: 276) containing the protease cleavage site, RNLV (RNLVPMVATVQIPVSLRSGGGGSGGGGSC) (SEQ ID No: 275) containing the same protease cleavage site as NLV-R and differing from NLV-R in the orientation of the viral epitope and the biotin peptide (Biotin-PFMRPHERNGFTVLC: SEQ ID No: 320) which does not contain the protease cleavage sequence and is used as a control peptide.
  • NLVR CSGGGGSGGGGAIPVSLRANLVPMVATV
  • RNLV RNLVPMVATVQIPVSLRSGGGGSGGGGSC
  • Biotin-PFMRPHERNGFTVLC SEQ ID No: 320
  • (D) Single chain fragment V (scFv) protein construct encoding for the same peptide sequence as used in (A) but contained within the scFv single polypeptide chain demonstrates activity against MDA-MB-231 cell line in vitro.
  • the protease recognition site within the ScFv construct is IPVSLRS (SEQ ID No: 310).
  • FIG. 8 Plasma stability of the antibody-peptide conjugate and specific targeting of tumour B cells.
  • A Recognition of a lymphoblastoid cell line or healthy B cells by CD8+cytomegalovirus specific cytotoxic T cells after labelling cells with Rituximab conjugated with MHC class I peptides derived from cytomegalovirus. There is no recognition of healthy B cells whereas there is recognition of target cells only in the presence of the viral peptide the T cells are specific for. This data demonstrates the specificity of the APEC for malignant cells compared with healthy tissue.
  • B The antibody peptide-epitope conjugate (APEC) was incubated at 37° C.
  • the peptide sequences used were NLV-Protease Cleavage-Reverse (CSGGGGSGGGGAIPVSLRANLVPMVATV) (SEQ ID No: 276) containing the protease cleavage site IPVSLRS (SEQ ID No: 310), VLE-Protease Cleavage (YVLEETSVMLIPVSLRSGGGGSGGGGSC) (SEQ ID No: 277) containing the protease cleavage site IPVSLRS (SEQ ID No: 310) and Biotin-RPH (Biotin-PFMRPHERNGFTVLC: SEQ ID No: 320) used as a control peptide without the protease cleavage sequence.
  • CSGGGGSGGGGAIPVSLRANLVPMVATV NLV-Protease Cleavage-Reverse (CSGGGGSGGGGAIPVSLRANLVPMVATV) (SEQ ID No: 276) containing the protease cleavage site IPVSLRS (SEQ ID No:
  • FIG. 10 (A) The dependency of external proteolytic activity: target cells are lightly fixed in paraformaldehyde or not and then incubated with either peptide (NLVPMVATV) (SEQ ID No: 21) or Cetuximab conjugated with either an irrelevant peptide (VLE) or cognate peptide (NLVPMVATV: SEQ ID No: 21-protease cleavage site) and incubated with NLVPMVATV (SEQ ID No: 21)-specific T-cells.
  • NLVPMVATV peptide
  • VLE irrelevant peptide
  • NLVPMVATV SEQ ID No: 21-protease cleavage site
  • FIG. 11 (A) Demonstration that cytokines can be used as targeting moiety with IL-2 (A) and IL-4 (B) being conjugated with HLA-class II peptide (DR7-restricted) PDDYSNTHSTRYVC (SEQ ID No: 309) and using the Biotin-RPH (Biotin-PFMRPHERNGFTVLC; SEQ ID No: 320) as a control peptide.
  • A Demonstration that cytokines can be used as targeting moiety with IL-2 (A) and IL-4 (B) being conjugated with HLA-class II peptide (DR7-restricted) PDDYSNTHSTRYVC (SEQ ID No: 309) and using the Biotin-RPH (Biotin-PFMRPHERNGFTVLC; SEQ ID No: 320) as a control peptide.
  • FIG. 12 T cell recognition by range of tumour cell lines. Eight HLA-A*0201 NCI-60 cell lines are all recognised by HLA-A*0201-restricted CMV-specific T-cells when pulsed with cognate antigen.
  • FIG. 13 in vitro targeting of human carcinoma cell lines using antibody-peptide-epitope conjugate (APEC) approach.
  • A Early data showing that Cetuximab-peptide conjugates could be used to target carcinoma cell lines. Positive control is cognate viral peptide pulsed tumours—as in FIG. 12 .
  • B The introduction of a protease cleavage site in the peptide is critical for effective targeting of tumour cells. Peptides not bearing a cleavage sequence (PC) are not cleaved and therefore not recognised by T-cells.
  • PC cleavage sequence
  • C Using Cetuximab-MMP2-NLVPMVATV (SEQ ID No: 21) APEC we can successfully target 4 out of 7 HLA-A*0201 NCI-60 cell lines. NCI-H522 and Colo205 are also weakly recognised, whereas HCT-116 is not recognised. Caki-2 is not HLA-A*0201 and serves only as a control.
  • D We have produced scFv protein based upon Cetuximab sequence and N-terminally linked MMP2-NLVPMVATV (SEQ ID No: 21). This agent is also able to target MDA-MB-231 tumour cells in vitro (shown in red).
  • E Assessment of in vitro potency of Cetuximab APEC.
  • NLVPMVATV NLVPMVATV
  • the peptides used were CSGGGGSGGGGAIPVSLRANLVPMVATV (SEQ ID No: 276) (‘NLVPMVATV-PC’) that contains the protease cleavage sequence AIPVSLR (SEQ ID No: 313), and CSGGGGSGGGGANLVPMVATV (SEQ ID No: 315) (‘NLVPMVATV’) that does not contain a protease cleavage site.
  • FIG. 14 (A) Immunohistochemistry of 4 human adenocarcinomas showing CD8+ T cells by immunohistochemistry reveal abundant CD8+ T-cell infiltrate in human carcinomas. (B) Using Anti-Muc1(SM3)-(Protease Cleavage)-NLVPMVATV (SEQ ID No: 21) APEC we can successfully target the pancreatic carcinoma cell line Panc-1. (C) Using Rituximab-Protease Cleavage)-NLVPMVATV (SEQ ID No: 21) APEC we can differentially target a model tumour B cell line (LCLs) (black bars) and avoid targeting healthy B cells (white bars).
  • LCLs model tumour B cell line
  • ‘U266+NLVPMVATV (SEQ ID No: 21)+T cell’ corresponds to the native 9 amino acid peptide alone as a free peptide epitope (i.e. no linker etc), and serves as a positive control as it is essentially the maximum possible response.
  • FIG. 21 ‘U266+NLVPMVATV (SEQ ID No: 21)+T cell’ corresponds to the native 9 amino acid peptide alone as a free peptide epitope (i.e. no linker etc), and serves as a positive control as it is essentially the maximum possible response.
  • NLVPMVATV NLVPMVATV
  • the peptides used were CSGGGGSGGGGAIPVSLRANLVPMVATV (SEQ ID No: 276) (‘NLVPMVATV-PC’) that contains the protease cleavage sequence AIPVSLR (SEQ ID No: 313), and CSGGGGSGGGGANLVPMVATV (SEQ ID No: 315) (‘NLVPMVATV’) that does not contain a protease cleavage site.
  • the agents of the invention are an example of re-directed immunotherapy. This refers to the concept of re-directing an existing immune response that normally target cells harbouring foreign antigens, to target unwanted cells in conditions such as cancer. The concept requires the presentation of marker antigens on unwanted cells such that they become a target for immune cells.
  • the agents of the present invention aim to circumvent all of the above problems whilst improving specificity, and exploit the fact that T cell antigens can be presented without first being internalised into a cell and being engaged in the classical antigen processing pathways.
  • T cell antigens can be presented without first being internalised into a cell and being engaged in the classical antigen processing pathways.
  • MHC Class-I processing pathway which continuously feeds peptides from the intracellular compartment via targeted intracellular proteolysis by the proteosome, peptide transport through the TAP and MHC Class-I peptide loading within the ER
  • antigens can also be presented without internalisation. This less directed mechanism relies on a short half-life of some MHC Class-I associated peptides due to low affinity of some MHC bound peptides to the MHC molecule.
  • T cell antigens e.g. peptides
  • T cell antigens can bind to MHC Class-II molecules and the present invention also circumvents the Class-II antigen processing pathway to directly load antigens at the cell membrane.
  • Group I CD1 molecules CD1a, CD1b and CD1c have been shown to present lipids to both cytotoxic alpha beta T cells as well as cytotoxic gamma delta T cells (Porcelli et al (1989) Nature, 341, 447-450).
  • the inventors have found that by introducing a cleavage site in close proximity to the T cell antigen, which cleavage site is selectively cleaved in the vicinity of the unwanted cells, the T cell antigen can be liberated from a targeting moiety in the vicinity of the unwanted cells and can become bound by, for example, empty MHC molecules or Group I CD1 molecules, and elicit a T cell response.
  • the agent can target cells expressing MHC Class-I molecules compared to only MHC Class-II expressing cells as in WO 95/17212; and specificity is increased by virtue of the cleavage site only being cleaved in the vicinity of the unwanted cells.
  • tumour cells secrete proteases that are required by tumours for invasion of local tissues and metastasis, and so by including a tumour-specific protease cleavage site in the agent, the specificity of the agent for the tumour is increased.
  • cleavage site to bypass the requirement for internalisation and classical processing in order for T cell antigens to be efficiently presented to T cells is a key advantage of the invention.
  • the presence of the cleavage site means that all cells become amenable to re-directed immunotherapy, and not just the relatively small population of antigen presenting cells that express MHC Class II molecules. This is especially important for tumours where most tumour cells do not express MHC Class II molecules.
  • the cleavage site also circumvents the challenges involved in ensuring that T cell antigens are not only successfully internalised, but that they correctly enter the appropriate cellular processing pathway to be presented on the cell surface.
  • the cleavage site By by-passing the need for internalisation, the cleavage site further provides the ability to target neighbouring tumour cells and stromal non-malignant tissue such as tumour-fibroblasts of blood vessels. It also circumvents tumour-evasion mechanisms that operate in classical antigen processing. All in all therefore, the cleavage site provides for a simpler and more effective method of re-directing immunotherapy to more cell types.
  • the targeting moiety of the agent functions to bring a T cell antigen directly into the vicinity of an unwanted cell.
  • the unwanted cell may then present the T cell antigen, once cleaved from the targeting moiety, on its surface such that the unwanted cell becomes a target for an existing T cell response. This allows for the redirection of an existing immune response to the unwanted cell directly, and so no co-stimulation by antigen presenting cells (APCs) is necessary.
  • APCs antigen presenting cells
  • Cross-presentation refers to the mechanism by which an antigen is transferred to a professional APC which, in turn, presents it on an MHC Class I molecule to a na ⁇ ve T cell so as to generate a primary cytotoxic T cell response specific for that antigen.
  • the process is important in the activation of na ⁇ ve T cells which must first recognise class I-associated peptide antigens and also encounter costimulators on APCs, or signals provided by helper T cells.
  • APCs as opposed to unwanted cells are targeted so that APCs may co-stimulate cytotoxic T cells and thereby generate a new immune response.
  • WO 2008/019366 discusses attaching antigens to a particle that can be phagocytosed by APCs such that the antigen can be released in the phagosome of the APC and thereby be cross-presented onto MHC Class I molecules.
  • EP 1 948 802 describes attaching an antigen to an antibody Fc fragment so as to promote internalisation of the antigen into the APC.
  • targeting of antigens to unwanted cells rather, the antigen is targeted to a specialised subset of APCs which, in turn, activate cytotoxic T cells to kill unwanted cells.
  • none of the documents describe the use and redirection of an existing immune response nor do they disclose that the T cell antigen can be presented on the surface of a cell without the need for internalisation.
  • a first aspect of the invention provides an agent for preventing or treating a condition characterised by the presence of unwanted cells, the agent comprising (i) a targeting moiety that is capable of targeting to the unwanted cells; and (ii) a T cell antigen, wherein the T cell antigen can be released from the targeting moiety by selective cleavage of a cleavage site in the agent in the vicinity of the unwanted cells.
  • targeting moiety we include the meaning of any moiety that is capable of targeting to the unwanted cells.
  • the targeting moiety is capable of targeting selectively to the unwanted cells.
  • the targeting moiety targets unwanted cells to a greater extent than it does normal cells, and most preferably targets only unwanted cells.
  • binding of the targeting moiety to normal cells may be tolerated if they can be functionally replaced by other therapeutic means or if they are not essential to life.
  • a targeting moiety that targets to a cancer cell as well as, for example, an endocrine tissue or organ is not precluded.
  • the targeting moiety acts to redirect an immune response to both unwanted cells and to other cells that can be functionally replaced by therapeutic means.
  • the tissue or organ may be sacrificed provided its function was either not essential to life, for instance in the case of the testes, prostate or pancreas, or could be supplied by hormone replacement therapy. Such considerations would apply to the thyroid gland, parathyroids, adrenal cortex and ovaries, for example.
  • the targeting moiety may be a moiety that is capable of targeting selectively to unwanted cells as opposed to wanted cells, wherein the unwanted cells may include cells whose presence in a host is undesired and optionally cells whose presence in the host is desired but whose presence can be functionally replaced by therapeutic means.
  • the targeting moiety targets selectively to unwanted cells as opposed to any other cells.
  • the targeting moiety is a specific binding partner of an entity expressed by or associated with the unwanted cell.
  • the expressed entity is expressed selectively on the unwanted cell.
  • the abundance of the expressed entity is typically 10 or 100 or 500 or 1000 or 5000 or 10000 higher on the unwanted cell than on other cells within the body to be treated.
  • the cleavage site provides additional specificity on where the T cell antigen is released and so the binding partner may bind an entity that is similarly or even underexpressed on unwanted cells relative to other cells within the body.
  • binding partner we include the meaning of a molecule that binds to an entity expressed by a particular cell.
  • the binding partner binds selectively to that entity.
  • the binding partner has a K d value (dissociation constant) which is at least five or ten times lower (i.e. higher affinity) than for at least one other entity expressed by another cell (e.g. a normal cell type), and preferably more than 100 or 500 times lower.
  • the binding partner of that entity has a K d value more than 1000 or 5000 times lower than for at least one other entity expressed by another cell (e.g. normal cell type).
  • K d values can be determined readily using methods well known in the art.
  • the binding partner may bind selectively to an entity expressed by an unwanted cell and by a normal cell provided that the normal cell may be functionally replaced or else is not essential to life.
  • anti-CD20 which targets all B cells
  • B cells healthy and malignant.
  • this can be tolerated as B cells are not critical for health.
  • melanoma lymphoma, prostate cancer, thyroid, testicular or ovarian cancer, targeting healthy counterpart tissue would also be tolerated.
  • the binding partner is one that binds to an entity that is present or accessible to the binding partner in significantly greater concentrations in or on unwanted cells than in any normal cells of the host.
  • the binding partner may bind to a surface molecule or antigen on the unwanted cell that is expressed in considerably higher amounts than on normal cells.
  • the binding partner may bind to an entity that has been secreted into the extracellular fluid by the unwanted cells to a greater extent than by normal cells.
  • the binding partner may bind to a tumour associated antigen which is expressed on the cell membrane or which has been secreted into tumour extracellular fluid.
  • the targeting moiety may be any of a polypeptide, a peptide, a small molecule or a peptidomimetic.
  • the targeting moiety is an antibody that binds to an antigen expressed by the unwanted cell.
  • Preferred antibody targets include: Her2/Neu (Epithelial malignancies); CD22 (B cells, autoimmune or malignant); EpCAM (CD326) (Epithelial malignancies); EGFR (epithelial malignancies); PMSA (Prostate Carcinoma); CD30 (B cell malignancies); CD20 (B cells, autoimmune, allergic or malignant); CD33 (Myeloid malignancies); membrane IgE (Allergic B cells); IgE Receptor (CD23) (Mast cells or B cells in allergic disease), CD80 (B cells, autoimmune, allergic or malignant); CD86 (B cells, autoimmune, allergic or malignant); CD2 (T cell or NK cell lymphomas); CA125 (multiple cancers including Ovarian carcinoma); Carbonic Anhydrase IX (multiple cancers including Renal Cell Carcinoma); CD70 (B cells
  • Particularly preferred antibodies include an anti-epidermal growth factor receptor antibody such as Cetuximab, an anti-Her2 antibody, an anti-CD20 antibody such as Rituximab, an anti-CD22 antibody such as Inotuzumab, an anti-CD70 antibody, an anti-CD33 antibody such as hp67.6 or Gemtuzumab, an anti-MUC1 antibody such as GP1.4 and SM3, an anti-CD40 antibody, an anti-CD74 antibody, an anti-P-cadherin antibody, an anti-EpCAM antibody, an anti-CD138 antibody, an anti-E-cadherin antibody, an anti-CEA antibody, and an anti-FGFR3 antibody.
  • an anti-epidermal growth factor receptor antibody such as Cetuximab, an anti-Her2 antibody, an anti-CD20 antibody such as Rituximab, an anti-CD22 antibody such as Inotuzumab, an anti-CD70 antibody, an anti-CD33 antibody such as hp67.6 or Gemtu
  • tumour-associated, immune cell-associated and infection reagent-related antigens which may be targeted by the targeting moiety are given in Table 1.
  • Tumour Associated Antigens Carcino-embryonic C46 (Amersham) Imaging and therapy Antigen 85A12 (Unipath) of colon/rectum tumours. Placental Alkaline H17E2 (ICRF, Imaging and therapy Phosphatase Travers & Bodmer) of testicular and ovarian cancers. Pan Carcinoma NR-LU-10 (NeoRx Imaging and therapy Corporation) of various carcino- mas including small cell lung cancer. Polymorphic HMFG1 (Taylor- Imaging and therapy Epithelial Mucin Papadimitriou, of ovarian cancer and (Human milk fat ICRF) pleural effusions.
  • ICRF Imaging and therapy Phosphatase Travers & Bodmer
  • the targeting moiety may be any compound or part thereof that specifically binds, in a non-immune sense, to an entity expressed by unwanted cells or otherwise becomes associated with the unwanted cells.
  • the specific binding partner may be any of a hormone, a growth factor, a cytokine, or a receptor ligand (e.g. agonist or antagonist).
  • cytokines have previously been used to target toxins to invading bacterial.
  • recombinant proteins have been produced which contain for example IL-2 and a binding domain-deleted Pseudomonas exotoxin protein (Lorderboum-Galski et al, 1988 (62)). This immunotoxin was effective in experimental animal models (Kozak et al, 1990 (63)). Fusion proteins have also been produced with IL-4, IL-6, alpha-MSH, EGF and TNF-alpha (reviewed in Waldmann 1992 (35)), all of which are appropriate for use as targeting moieties in the present invention.
  • Particularly useful targeting moieties include cytokines such as IL-2, EGF, VEGF, Flt3L, HGF, IGF, IL-6, or IL-4.
  • IL-2 and IL-4 can target to adult T cell leukaemia/lymphoma cells which express the high affinity IL-2 receptor whereas normal resting T-cells do not, or to T-cells expressing the IL-4 receptor.
  • the monoclonal antibody MR6 which binds to the human IL-4 receptor, can inhibit the IL-4 induced proliferation of cloned helper T cells and the production of IgE by polyclonal B cells (Larche et al, 1988 (36)).
  • Such targeting moieties may be used to eliminate a lymphoid cell subpopulation in autoimmune disease or allergy.
  • IGF-1 and IGF-11 Insulin like growth factors are preferentially taken up by malignant cells and so may be used to target tumour cells.
  • EGF can be used to target malignant cells which upregulate the EGF receptor.
  • tumour associated blood vessels overexpress VEGF receptor and so can be targeted by the family of VEGF growth factors.
  • Flt3 receptor is overexpressed in leukaemias and may be a therapeutic target for acute and chronic leukaemias and myeloproliferative disorders.
  • Myeloma cells express IL-6 receptor and also secrete IL-6 which acts in an autocrine fashion to stimulate cell proliferation.
  • IL-6 may be used as a targeting moiety for myeloma.
  • the targeting moiety is melanoma stimulating hormone (MSH) which binds to the MSH receptor which is expressed in high numbers in melanoma cells.
  • MSH melanoma stimulating hormone
  • a plurality of such antibodies has become commercially available.
  • Other methods of identifying suitable binding partners for a given unwanted cell include genetic approaches (eg microarray), proteomic approaches (eg differential Mass spectrometry), immunological approaches (eg immunising animals with tumour cells and identifying antibody-secreting clones which specifically target malignant cells) and in silico approaches wherein targets are identified using a systems biology approach.
  • CD52 T-cell lymphoma, T-cells and B-cell lymphomas Autoimmune induced immune cells may also be targeted.
  • CD6 (Tp120) T-cell lymphoma, T-cells and B-cell lymphomas such as chronic lymphocytic leukaemia.
  • CD70 tumor necrosis factor superfamily Lymphoma and many types of carcinoma member 7, TNFSF7, CD27LG, CD27L
  • CD74 major histocompatibility class II invariant Lymphoma and many types of carcinoma chain, MH2
  • CD80 B7-1, CD28LG1 Lymphoma and many types of carcinoma CD86 (B7-2, CD28LG2) Lymphoma and many types of carcinoma
  • CEA anticarcinoembryonic antigen
  • CEACAM3 carcinoembryonic antigen-related Many types of carcinoma, cell adhesion molecule 3, CGM1, CD66d
  • CEACAM5 carcinoembryonic antigen-related Many types of carcinoma, cell adhesion molecule 5
  • CEA, CD66e CEACAM8 (carcinoembryonic antigen-related Many types of carcinoma, cell adhesion molecule 8, NCA-95, nonspecific cross- reacting antigen 95 kDa, granulocyte cell antigen, CGM6, CD66b) ClfA
  • CSF2 colony stimulating factor 2 (granulocyte- Myeloid diseases macrophage), granulocyte-macrophage colony stimulating factor, GM-CSF) CSF2RA (colony-stimulating factor Myeloid diseases 2(granulocyte-macrophage) receptor alpha subunit, GM-CSF-R-alpha, CD116)
  • CSPG4 chondroitin sulfate proteoglycan 4, Many types of carcinoma, lymphoma, sarcoma high molecular weight-melanoma-associated and leukaemia antigen, HMW-MAA) CTLA4 (cytotoxic T lymphocyte-associated Regulatory T-cells and unwanted immune cells.
  • ED-B fibronectin extra domain B
  • EGFR epithelial growth factor receptor
  • ERBB1 HER1, HER-1, ERBB
  • EPCAM epithelial cell adhesion molecule
  • epithelial glycoprotein 2 EGP-2
  • epithelial cell adhesion molecule Ep- CAM, KSA, KS1/4 antigen, M4S, tumor antigen 17-1A, EpCAM, CD326
  • ERBB2 epidermal growth factor receptor 2
  • FCER2 immunoglobulin E Fc receptor low Many types of carcinoma, lymphoma, sarcoma affinity II, Fc epsilon RII, CD23) and leukaemia in B-cells.
  • FCGR1 immunoglobulin G Fc receptor high Many types of carcinoma, lymphoma, sarcoma affinity I, Fc gamma RI, CD64, encoded by and leukaemia.
  • human FCGR1A, FCGR1B, FCGR1C fibrin II beta chain (NH2 terminus) Many types of carcinoma, lymphoma, sarcoma and leukaemia.
  • FLT1 (fms-related tyrosine kinase 1, vascular Many types of carcinoma, sarcoma, lymphoma, endothelial growth factor receptor 1, VEGFR-1, sarcoma and leukaemia. In particular tumour VEGFR, FLT, FRT, vascular permeability factor blood vessels. receptor) FOLH1 (folate hydrolase, prostate specific Many types of carcinoma, lymphoma, sarcoma membrane antigen, PSMA) and leukaemia in particular prostate carcinoma and unwanted prostate tissue.
  • FOLR1 farnesoid receptor 1
  • FOLR1 farnesoid receptor 1
  • GD2 ganglioside Brain tumours and unwanted neuronal tissue GD3 ganglioside Brain tumours and unwanted neuronal tissue.
  • GLP1R glucagon-like peptide 1 receptor
  • GPNMB glycoprotein transmembrane NMB
  • HGFIN hapten NP-cap (4-hydroxy-3-nitrophenacetyl
  • HAVCR1 hepatitis A virus cellular receptor 1, Hepatitis A infected cells.
  • HBV hepatitis B virus
  • HBV infected cells HCMV (human cytomegalovirus)
  • glycoprotein HCV hepatitis C virus
  • HCV infected cells heat shock protein 90 homolog
  • carcinoma, lymphoma, sarcoma and leukaemia HGF hepatocyte growth factor, scatter factor, Hepatoma and hepatocellular carcinoma.
  • SF hepatopoeitin A
  • HIV-1 human immunodeficiency virus HIV infected cells HLA-DR10 (DRB1*1001) Autologous or Allogeneic MHC Class-II expressing cells including tumour cells HLA-DRB (HLA-DR beta) Autologous or Allogeneic MHC Class-II expressing cells including tumour cells HSV (herpes simplex virus) HSV infected cells ICAM1 (intercellular adhesion molecule 1, Many types of carcinoma, lymphoma, sarcoma ICAM-1, CD54) and leukaemia ICAM3 (intercellular adhesion molecule 3, Many types of carcinoma, lymphoma, sarcoma ICAM-3, CD50) and leukaemia Membrane Immunoglobulin IgE IgE secreting B-cells and Plasma cells (cuasing allergic disease).
  • IgE Fc IgE secreting B-cells and Plasma cells (cuasing allergic disease).
  • IGF1R insulin-like growth factor 1 receptor, Most types of carcinoma, lymphoma, sarcoma IGF1-R, IGF-1R, CD221) and leukaemia IGHE connecting region (CO) M1 prime (in IgE secreting cells such as B-cells and plasma alternatively spliced heavy chain of membrane cells.
  • IgE on B cells IL2RA (interleukin-2 receptor, alpha subunit, IL- B-cells and T-cells in either malignant or 2RA, TAC, CD25) autoimmune disease.
  • IL2RB interleukin-2 receptor beta subunit, IL- B-cells and T-cells in either malignant or 2RB, p70, CD122
  • IL5RA interteukin 5 receptor alpha subunit, B-cells and T-cells in either malignant or CD125
  • IL6R interleukin 6 receptor, IL-6R, CD126
  • ITGA2 ⁇ integrin alpha 2, GPIa subunit of the Many types of carcinoma, lymphoma, alpha2beta1 integrin (VLA-2, collagen leukaemias.
  • ITGA2B_ITGB3 integrated with ITGA2B_ITGB3
  • ITGA4 integrated with ITGA4 subunit, CD49d
  • ITGA4_ITGB7 integrated with ITGA4_beta7, integrin Many types of carcinoma, lymphoma, ⁇ 4 ⁇ 7, lymphocyte Peyer's patch adhesion leukaemias.
  • ITGA5 integrated molecule 1, LPAM-1) ITGA5 (integrin alpha 5 subunit, CD49e) Many types of carcinoma, lymphoma, leukaemias.
  • ITGAE_ITGB7 integrated alphaE_beta7, integrin Many types of carcinoma, lymphoma, ⁇ E ⁇ 7, human mucosal lymphocyte antigen 1, leukaemias.
  • HML-1) ITGAL integratedin alpha L subunit, lymphocyte Many types of carcinoma, lymphoma, function associated antigen 1, CD11a) leukaemias.
  • ITGAV_ITGB3 (integrin alphaV_beta3, integrin Many types of carcinoma, lymphoma, ⁇ V ⁇ 3, CD51_GPIIIa, vitronectin receptor, VNR, leukaemias.
  • CD51_CD61 ITGB1 (integrin beta1 subunit, GPIIa, CD29) Many types of carcinoma, lymphoma, leukaemias.
  • ITGB2 (integrin beta2 subunit, LFA-1, MAC-1, Many types of carcinoma, lymphoma, CD18) leukaemias.
  • KDR kinase insert domain receptor, vascular Many types of carcinoma, lymphoma, endothelial growth factor receptor 2, VEGFR2, leukaemias.
  • LTA lymphotoxin alpha, TNF superfamily Many types of carcinoma, lymphoma, member 1, TNFSF1, LT) leukaemias.
  • LTB lymphotoxin beta, TNF superfamily Many types of carcinoma, lymphoma, member 3, TNFSF3, p33) leukaemias.
  • MET metal proto-oncogene, hepatocyte growth Many types of carcinoma, lymphoma, factor HGF receptor, HGFR, scatter factor SF leukaemias.
  • MS4A1 membrane-spanning 4-domains Many types of carcinoma, lymphoma, subfamily A member 1, CD20) leukaemias.
  • MSLN mesothelin, pre-pro-megakaryocyte- Many types of carcinoma, lymphoma, potentiating factor, megakaryocyte potentiating leukaemias. factor, MPF, CAK1
  • MST1R microphage stimulating 1 receptor, Many types of carcinoma, lymphoma, macrophage stimulating protein receptor, MSP leukaemias.
  • MSTN myostatin, growth differentiation factor Many types of carcinoma, lymphoma, 8, GDF8) leukaemias.
  • MUC1 mimerase 1
  • MUC1 sialylated carbohydrate, tumour- Many types of carcinoma, lymphoma, associated (CA242, cancer antigen 242) leukaemias.
  • MUC16 (mucin 16, MUC-16, cancer antigen Many types of carcinoma, lymphoma, 125, CA125) leukaemias.
  • MUC5AC (mucin 5AC, mucin 5 subtypes A and Many types of carcinoma, lymphoma, C tracheobronchial/gastric) leukaemias.
  • N-glycolyl GM3 ganglioside (N- Brain tumours and unwanted neural tissue.
  • glycolylneuraminic acid (NeuGc, NGNA) GM3 ganglioside, NeuGcGM3) NCA-90 (nonspecific cross-reacting antigens
  • NCAM1 neural cell adhesion molecule 1
  • NCAM-1 Brain tumours and unwanted neural tissue also NCAM-1, NCAM, CD56
  • Nectin-4 Many types of carcinoma, lymphoma, sarcoma and leukaemia NGF (nerve growth factor, nerve growth factor Many types of carcinoma, lymphoma, sarcoma beta polypeptide, NGFB, beta-NGF) and leukaemia NIP-cap (3-iodo-4-hydroxy-5-nitrophenyl-acetyl Many types of carcinoma, lymphoma, sarcoma caproic acid) and leukaemia NRP1 (neuropilin 1, NRP, vascular endothelial Many types of carcinoma, lymphoma, sarcoma cell growth factor 165 receptor, VEGF165 and leukaemia receptor, VEGF165R, CD304) PDGFRA (platelet-derived growth factor Many types of carcinoma, lymphoma, sarcoma receptor alpha subunit, PDGFR2, CD140a) and leukaemia phosphatidylserine Many types of carcinoma, lymphoma, sarcoma and leukaemia
  • PSCA prostate stem cell antigen
  • RSV human respiratory syncytial virus, RSV infected cells glycoprotein F
  • RTN4 reticulon 4, neurite outgrowth inhibitor
  • SDC1 syndecan-1, CD138
  • SELE E-selectin, CD62E
  • SELL L-selectin, CD62
  • SELP P-selectin, CD62
  • SFRP1 selected frizzled-related protein 1, Many types of carcinoma and lymphoma.
  • fusion regulatory protein 1, FRP-1) SLAMF7 (SLAM family member 7, CD2 subset Many types of unwanted cells including tumour 1, CS1, CD2-like receptor-activating cytotoxic cells and those involved in autoimmune cells, CRACC, 19A24, CD319) disease.
  • SLC3A2 concentrate carrier family 3 (activators of Many types of unwanted cells including tumour dibasic and neutral amino acid transport) cells and those involved in inflammatory member 2, 4F2 antigen heavy chain, 4F2HC, disease.
  • TGFB1 transforming growth factor beta1, TGF Many types of unwanted cells including tumour beta) cells and those involved in fibrotic disease.
  • TGFB2 transforming growth factor beta 2
  • TNF tumor necrosis factor
  • TNFSF2 tumor necrosis factor
  • TNFA tumor necrosis factor
  • TNFRSF10A tumour necrosis factor receptor
  • TNFR tumour cell superfamily member 10A
  • DR4 TNF-related apoptosis- disease.
  • TNFRSF10B tumor necrosis factor receptor
  • TNFRSF10B tumor necrosis factor receptor
  • TNFRSF10B tumor necrosis factor receptor
  • TNFRSF12A tumor necrosis factor receptor
  • TNFR tumour
  • FGF inflammatory growth factor
  • Fn14 TNF-like weak inducer of apoptosis (Tweak) receptor
  • Tweak receptor Tweak receptor
  • TweakR Tweak receptor
  • TweakR TweakR
  • CD30 tumor necrosis factor receptor
  • TNFRSF9 tumor necrosis factor receptor
  • tumour TNFR
  • 4-1BB T cell cells and those involved in inflammatory and antigen ILA, CD137 autoimmune disease.
  • TNFSF11 tumor necrosis factor (TNF)
  • tumour superfamily member 11 tumour superfamily member 11
  • osteoclast cells and those involved in inflammatory and differentiation factor, ODF, OPGL, RANKL
  • TRANCE CD254
  • TNFSF13 tumor necrosis factor (TNF)
  • tumour superfamily member 13 a proliferation- cells and those involved in inflammatory and including ligand, APRIL, CD256 autoimmune disease.
  • TNFSF13B tumor necrosis factor
  • TNFSF14 tumor necrosis factor
  • TNFSF4 tumor necrosis factor
  • tumour superfamily member 4 OX40 ligand, OX-40L, cells and those involved in inflammatory and TAX transcriptionally-activated glycoprotein 1, autoimmune disease.
  • TYRP1 tyrosinase-related protein 1, 5,6- Multiple carcinomas. dihydroxyindole-2-carboxylic acid oxidase, DHICA oxidase, TRP1, melanoma antigen gp75
  • VAP-1 vascular adhesion protein
  • VEGFA vascular endothelial growth factor A, Multiple carcinomas and hepatomas.
  • VEGF-A, VEGF VIM (vimentin) Multiple carcinomas and hepatomas.
  • antibody includes but is not limited to polyclonal, monoclonal, chimeric, single chain, Fab fragments, fragments produced by a Fab expression library and bispecific antibodies.
  • fragments include fragments of whole antibodies which retain their binding activity for a target substance, Fv, F(ab′) and F(ab′)2 fragments, as well as single chain antibodies (scFv), fusion proteins and other synthetic proteins which comprise the antigen-binding site of the antibody.
  • a targeting moiety comprising only part of an antibody may be advantageous by virtue of optimising the rate of clearance from the blood and may be less likely to undergo non-specific binding due to the Fc part.
  • dAbs domain antibodies
  • diabodies camelid antibodies
  • engineered camelid antibodies the antibodies and fragments thereof may be humanised antibodies, which are now well known in the art (Janeway et al (2001) Immunobiology., 5th ed., Garland Publishing); An et al (2009) Therapeutic Monoclonal Antibodies : From Bench to Clinic, ISBN: 978-0-470-11791-0).
  • asymmetric IgG-like antibodies eg triomab/quadroma, Trion Pharma/Fresenius Biotech; knobs-into-holes, Genentech; Cross MAbs, Roche; electrostatically matched antibodies, AMGEN; LUZ-Y, Genentech; strand exchange engineered domain (SEED) body, EMD Serono; biolonic, Merus; and Fab-exchanged antibodies, Genmab
  • symmetric IgG-like antibodies eg dual targeting (DT)-Ig, GSK/Domantis; two-in-one antibody, Genentech; crosslinked MAbs, karmanos cancer center; mAb 2 , F-star; and Cov X-body, Cov X/Pfizer
  • IgG fusions eg dual variable domain (DVD)-Ig, Abbott; IgG-like bispecific antibodies, Eli Lilly; Ts2Ab, Medimmune/AZ; BsAb, ZymoGenetics;
  • the antibody may possess any of the antibody-like scaffolds described by Carter (2006) “Potent antibody therapeutics by design”, Nat Rev Immunol. 6(5): 343-57, and Carter (2011) “Introduction to current and future protein therapeutics: a protein engineering perspective”, Exp Cell Res. 317(9): 1261-9. incorporated herein by reference, together with the specificity determining regions described herein.
  • the term “antibody” also includes affibodies and non-immunoglobulin based frameworks. Examples include adnectins, anticalins, affilins, trans-bodies, darpins, trimerX, microproteins, fynomers, avimers, centgrins and kalbitor (ecallantide).
  • antibody fragments rather than whole antibodies
  • the smaller size of the fragments may lead to improved pharmacological properties, such as better penetration of solid tissue.
  • antigen-binding fragments such as Fab, Fv, ScFv and dAb antibody fragments can be expressed in and secreted from E. coli or yeast, thus allowing convenient production in the laboratory and economical production on a commercial scale.
  • the antibody may be of any of the IgG, IgE, IgA, IgM and IgD classes and may be derived from any species. If the antibody is an IgG, it may be any of IgG1, IgG2, IgG3 or IgG4. It is preferred, however, that when the agent is for administration to a particular host, that the antibody, or at least the constant regions thereof, are derived from that host. For example, when the agent is to be administered to a human, the antibody is preferably a human antibody or a humanized antibody, and so on.
  • Suitable antibodies that bind to particular antigens expressed by unwanted cells can be made by the skilled person using technology long-established in the art.
  • Methods of preparation of monoclonal antibodies and antibody fragments are well known in the art and include hybridoma technology (Kohler & Milstein (1975) “Continuous cultures of fused cells secreting antibody of predefined specificity. Nature 256: 495-497); antibody phage display (Winter et al (1994) “Making antibodies by phage display technology.” Annu. Rev. Immunol. 12: 433-455); ribosome display (Schaffitzel et al (1999) “Ribosome display: an in vitro method for selection and evolution of antibodies from libraries.” J. Immunol.
  • the targeting moiety may be a non-specific molecule that is capable, following administration to a subject, of accumulating in the vicinity of the unwanted cells.
  • macromolecules accumulate non-specifically in tumours.
  • Macromolecules known to accumulate in tumours non-specifically include albumin, immunoglobulins, transferrin, liposomes, nanoparticles (eg colloidal nanoparticles) and biodegradable polymers including dextrans, polyethylene glycol, polylysine and hydroxypropylmethylacrylamide.
  • Macromolecules accumulate in human xenografted tumours in nude mice up to about 2.0% of administered dose per gram of tumour.
  • Macromolecules such as polyethylene glycol and dextrans have been found to modify the clearance rate of substances to which they are attached and modify their concentration in tumours (Melton et al, 1987; Eno-Ammoquaye et al, 1996). In exceptional tumours, a non-specific macromolecule may accumulate in greater concentration than an antibody directed at the secreted antigen (Searle et al, 1981).
  • EPR Enhanced Permeability and Retention
  • the targeting moiety may be any of these macromolecules which accumulate in tumours.
  • the macromolecule used in the invention is hydrophilic and is characterised by being soluble in body fluids and in conventional fluids for parenteral administration.
  • the macromolecule is biodegradable so that systemic accumulation during repeated administration is avoided.
  • the molecular weight and size of the agent comprising such a macromolecule targeting moiety exceeds that of the renal threshold for urinary excretion (MW 60 000), as this helps the blood concentration to be sufficient to provide an effective blood:tumour concentration gradient.
  • a molecular weight of up to at least 800 000 is generally suitable, for example up to 160 000.
  • the macromolecule is preferably one which is not readily captured by the reticuloendothelial system. The molecular weights given exclude any water of hydration.
  • Macromolecules that are available as sub-units and are not biodegradable may be linked by biodegradable linking units so that the non-biodegradable components are filtered through the kidneys and excreted in the urine.
  • the polymer used to make the macromolecule is not biodegradable such that the molecular weight of any non-biodegradable portion of the conjugate should be less than the renal threshold (circa 70000) so that after degradation of the biodegradable portion the residual non-biodegradeable portion is excreted through the kidneys.
  • the macromolecule may be any of a dextran; a polyamino acid; a nanoparticle (eg colloidal nanoparticle), or a non-tumour-specific protein such as an immunoglobulin, an albumin or a transferrin.
  • a dextran e.g colloidal nanoparticle
  • a non-tumour-specific protein such as an immunoglobulin, an albumin or a transferrin.
  • it may be a copolymer of styrene and maleic anhydride, or may be polyaspartic acid, poly-L-lysine, polyethyleneimine or polyethylene glycol.
  • MDEPT melanocyte-directed enzyme prodrug therapy
  • the unwanted cell may be any cell whose presence in a host is undesired.
  • the cell may be a tumour cell (benign or malignant), a cell from a tumour microenvironment such as tumour fibroblasts or tumour blood vessels, a virally infected cell, a cell introduced as part of gene therapy, or a normal cell which one wishes to destroy for a particular reason.
  • a subpopulation of immune cells such as T lymphocytes in autoimmune disease or such as B lymphocytes in allergic disease.
  • a ‘condition characterised by the presence of unwanted cells’ we include any biological or medical condition or disorder in which at least part of the pathology is mediated by the presence of unwanted cells.
  • the condition may be caused by the presence of the unwanted cells or else the presence of the unwanted cells may be an effect of the condition.
  • examples of particular conditions include tumours (benign or malignant), autoimmune conditions, cardiovascular diseases, degenerative diseases, diabetes, allergic disease (eg asthma), neurodegenerative diseases such as Alzheimer's, transplantation patients and infectious diseases.
  • the agent also has utility in regenerative medicine (eg laboratory grown organs or tissues). It is particularly preferred if the condition is a tumour (eg a malignant disease) and the unwanted cells are tumour cells or tumour associated tissue.
  • the unwanted cells may represent cells of the adaptive or innate immune response, preferably T cells, but more preferably B cells.
  • the unwanted cells may represent cells within atheromatous lesions such as macrophages.
  • the unwanted cells may represent cells which induce the neurodegenerative changes, for instance in Alzheimer's disease they may be microglia or astrocytes.
  • any cell which facilitates the process of degeneration or apoptosis may be considered a target.
  • processes such as aging where unwanted tissue builds up, for example in benign prostatic hyperplasis non-malignant prostatic tissue would be a preferred target.
  • tissue mast cells may be considered an ideal target, but also IgE secreting cells such as plasma cells or B cells.
  • IgE secreting cells such as plasma cells or B cells.
  • alloreactive lymphocytes would represent a preferred target cell.
  • infectious disease any cell harbouring a virus, bacteria or fungal pathogen may be considered a preferred target cell for example an HIV infected cell.
  • the unwanted cell is not an antigen presenting cell such as a professional antigen presenting cell with cross-presentation capability.
  • T cell antigen we include the meaning of any antigen which can be presented to a T cell so as to elicit a T cell response.
  • the T cell antigen may be presented to a T cell by an MHC molecule or by a Group I CD1 molecule. Once the antigen is presented on the surface of the cell, the cell is recognised as foreign and becomes the target of T cells, some of which have the natural function of eliminating foreign cells either infected by foreign organisms such as viruses, fungi, bacteria, mycobacteria or protozoa, or which have become cancerous (eg malignant).
  • the T cell antigen may be one that is capable of being presented by a molecule on an unwanted cell.
  • the T cell antigen may be presented on a cell other than an unwanted cell but still in the vicinity of an unwanted cell, and by virtue of subsequent T cell activation, an unwanted cell is killed, for example by local production of cytokines by activated T cells.
  • Such indirect killing may be desirable, for example to target tumour blood vessels and/or stromal cells which support tumour growth.
  • the T cell antigen is one that can elicit an existing T cell response in the subject to which the agent of the invention is administered.
  • the T cell antigen is not one which generates a new primary T cell response for that antigen via cross-presentation in APCs.
  • the T cell antigen is one to which a number of T cells in the subject are already sensitised to. Determining whether a subject's cells are sensitised to a given antigen can be done by contacting isolated peripheral mononuclear blood cells from the subject with the antigen and using standard assays for cell proliferation, as described further below and in the Examples.
  • the agent of the invention is not one which generates a new T cell response specific for the T cell antigen contained in it.
  • the invention includes an agent for preventing or treating a condition characterised by the presence of unwanted cells, the agent comprising (i) a targeting moiety that is capable of targeting to the unwanted cells; and (ii) a T cell antigen, wherein the T cell antigen can be released from the targeting moiety by selective cleavage of a cleavage site in the agent in the vicinity of the unwanted cells, and wherein the T cell antigen is capable of eliciting an existing T cell response in a subject.
  • T cell we include all types of T cell including CD4+, CD8+, ⁇ T cells, and NK-T cells.
  • the T cell is a cytotoxic T cell such that a cytotoxic T cell response is elicited.
  • the mechanism of antigen presentation will depend upon the type of T cell.
  • CD4+ T cells recognise peptide antigens bound to MHC Class II molecules
  • CD8+ T cells recognise peptide antigens bound to MHC Class I molecules
  • ⁇ T cells recognise small phosphorylated molecules, alkyl amines or lipids bound to group I CD1 molecules
  • NK-T cells recognise lipid antigens bound to group I CD1 molecules. It is understood that any presentation route may be used provided that the antigen elicits a T cell response.
  • the T cell antigen may be one that is capable of binding to an MHC Class I or MHC Class II molecule, or one that is capable of binding to a group I CD1 molecule.
  • the T cell antigen is an immunodominant antigen (eg an antigen that elicits an existing immunodominant response).
  • immunodominant we include the meaning that the antigen elicits a T cell response with high magnitude, sensitivity, tissue homing characteristics and efficiency in killing antigen bearing cells.
  • an immunodominant response comprises more than 0.1% of a subject's CD8 + or CD4 + T cells. Determining the extent of a T cell response for a given antigen can be done for example by contacting isolated peripheral mononuclear blood cells from the subject with the antigen and using standard assays for cell proliferation known in the art.
  • Suitable assays for determining the extent of an immune response include ELISpot, intracellular cytokine staining, HLA-peptide tetramer staining, proliferation assay, activation assays (eg CD69), CD107 mobilisation assays or metabolic assays (eg MTT).
  • T cell antigens include any of a peptide, a polypeptide, a phosphopeptide or a lipid such as a phospholipid or a sphingolipid, and further examples of each of these are provided below.
  • the T cell antigen When the T cell antigen is a peptide or polypeptide, typically it is one that is capable of being recognised by a T cell receptor when bound to an MHC molecule.
  • the T cell antigen may be an MHC Class I restricted antigen that binds only to MHC Class I molecules, or it may be an MHC Class II restricted antigen that binds only to MHC Class II molecules. It is appreciated that the antigen may bind only to particular variant MHC Class I and/or MHC Class II molecules (e.g. natural variants found in particular subjects), or that the antigen may be capable of binding to any MHC Class I and/or MHC Class II molecule (i.e. the antigen is promiscuous).
  • the T cell antigen is capable of binding to a MHC Class I molecule such as any of HLA-A, HLA-B and HLA-C. Since MHC Class I molecules are expressed on all cell types, this allows to agent of the invention to redirect an immune response to any unwanted cell.
  • the peptide is capable of binding to HLA types A1, A2.1, A3.2, A11, A24, B7, B8, B35, B44, Cw1, Cw2, Cw3, Cw4 and Cw6 or mixtures thereof, which are believed to cover more than 90% of the Caucasian and Asian populations.
  • the T cell antigen is capable of binding to a MHC Class II molecule such as any of HLA-DP, HLA-DQ or HLA-DR.
  • MHC Class II types include DR1, DR3, DR4, DR7, DR52, DQ1, DQ2, DQ4, DQ8 and DP1.
  • MHC Class II molecules are expressed on immune cells including antigen presenting cells such as dendritic cells, B cells and macrophages.
  • the agent of the invention may be used to treat conditions such as lymphomas or autoimmune diseases.
  • Another promiscuous peptide that may be used is the tetanus fragment C peptide.
  • the T cell antigen is an immunogenic peptide that is recognised by an MHC molecule.
  • Such peptides usually have a length of 9 to 22 amino acids (for recognition in the MHC Class II complex) or of 8 to 13 amino acids (for recognition in the MHC Class I complex).
  • the peptide is an immunodominant peptide.
  • immunodominant peptides include viral derived peptides that elicit endogenous anti-viral responses.
  • the peptide may be derived from an endogenous virus such as Varicella-Zoster virus, Herpes simplex virus, cytomegalovirus, Epstein Barr virus, or influenza.
  • Particularly preferred examples include peptides derived from human cytomegalovirus (CMV or Human herpesvirus 5/HHV5) or Epstein-Barr Virus (EBV or HHV4); herpesviruses such as HHV1, HHV2 and HHV3; influenza virus A; influenza virus B; rhinovirus; adenovirus; and Hepadnaviridae.
  • HHV5 human cytomegalovirus
  • the immunodominant antigens are well characterised (see Sylwester A W et al J Exp Med. 2005 Sep. 5; 202(5):673-85, incorporated herein by reference), and any such antigen described in Sylwester et al may be used in the present invention.
  • Sylester et al synthesised consecutive 15mer peptides, overlapping by 10 amino acids, for 213 predicted human CMV proteins. This generated 13,687 peptides that were arranged in ORF or sub-ORF specific mixes.
  • Peptides derived from ORFs UL55 (gB), UL 83 (pp65), UL 86, UL 99 (pp28), UL 122 (IE2), UL 36, UL 48, UL32 (pp150), UL 113, IRS-1, UL 123 (IE1), UL25, UL 141, UL 52 and UL 82 (pp71) were found to elicit the most CD 4+ T cell responses, and so it is particularly preferred if the peptide is derived from one of these ORFs.
  • peptides derived from ORFs UL48, UL83 (pp66), UL 123 (IE1), UL 123 (IE2), US 32, UL 28, US 29, US3, UL 32 (pp150), UL 55 (gB), UL 94, UL 69, UL 105, UL 82 (pp71) and UL 99 (pp28) were found to elicit the most CD 8+ T cell responses, and so it is particularly preferred if the peptide is derived from one of these ORFs.
  • cytomegalovirus T cell antigens are listed below.
  • CD8+ T cell epitopes for cytomegalovirus antigens such as IE1 include YILEETSVM (SEQ ID No: 2), YVLEETSVM (SEQ ID No: 3), VLEETSVML (SEQ ID No: 4), VLAELVKQI (SEQ ID No: 5), ATTFLQTMLR (SEQ ID No: 6), EVISVMKRR (SEQ ID No: 7), CRVLCCYVL (SEQ ID No: 8), ELRRKMMYM (SEQ ID No: 9), ELKRKMIYM (SEQ ID No: 10), QIKVRVDMV (SEQ ID No: 11), CVETMCNEY (SEQ ID No: 12), RRKMMYMCY (SEQ ID No: 13), KRKMIYMCY (SEQ ID No: 14), RRIEEICMK (SEQ ID No: 15), DELRRKMMY (SEQ ID No: 16), KEVNSQLSL (SEQ ID No: 17),
  • CD4+ T cell epitopes for cytomegalovirus antigens such as pp65 include PQYSEHPTFTSQYRIQ (SEQ ID No: 47), FTSQYRIQGKLEYRHT (SEQ ID No: 48), LLQTGIHVRVSQPSL (SEQ ID No: 49), NPQPFMRPHERNGFT (SEQ ID No: 50), EPDVYYTSAFVFPTK (SEQ ID No: 51), IIKPGKISHIMLDVA (SEQ ID No: 52), AGILARNLVPMVATV (SEQ ID No: 53), KYQEFFWDANDIYRI (SEQ ID No: 54); for gB they include DYSNTHSTRYV (SEQ ID No: 55), CMLTITTARSKYPYH (SEQ ID No: 56), and VFETSGGLVVFWQGI (SEQ ID No: 57); for 1E1 they include VRVDMVRHRIKEHMLKKYTQ (SEQ ID No: 58) and NYI
  • CD8+ and CD4+ T cell epitopes identified in EBV lytic and latent cycle proteins (adapted from Hislop et al) CD8+ T cell epitopes EBV Epitope Epitope SEQ ID HLA Antigen coordinates sequence No restriction Latent cycle proteins EBNA1 72-80 RPQKRPSCI 61 B7 407-415 HPVGEADYF 62 B53 407-417 HPVGEADYFEY 63 B35.01 528-536 IPQCRLTPL 64 B7 574-582 VLKDAIKDL 65 A2.03 EBNA2 14-23 YHLIVDTDSL 66 B38 42-51 DTPLIPLTIF 67 A2/B51 234-242 RPTELQPTP 68 B55 EBNA3A 158-166 QAKWRLQTL 69 B8 176-184 AYSSWMYSY 70 A30.02 246-253 RYSIFFDY 71 A24 325-333 FLRGRAYGL 72 B8 378-387 KRP
  • immunodominant peptides include HLA-A*0201-restricted epitopes (HCMV pp65 495-504—NLVPMVATV (SEQ ID No: 21), HCMV IE1 VLEETSVML (SEQ ID No: 4), EBV LMP-2 356-364 FLYALALLL (SEQ ID No: 127), EBV BMLF-1 259-267 GLCTLVAML (SEQ ID No: 155)); HLA-A*0101-restricted epitopes (HCMV pp50 245-253—VTEHDTLLY (SEQ ID No: 44); HCMV pp65 363-373—YSEHPTFTSQY) (SEQ ID No: 20); HLA-A*0301-restricted epitopes (HCMV pp50—TVRSHCVSK (SEQ ID No: 46),); HLA-B*0702-restricted epitopes (HCMV pp65 417-426 TPRVTGGGAM (SEQ ID No
  • the T cell antigen may be one derived from a live vaccine such as Measles, Mumps, Rubella (MMR) or HHV3; or one derived from intracellular bacteria such as mycobacteria, particularly those evoked through immunization with BCG.
  • a live vaccine such as Measles, Mumps, Rubella (MMR) or HHV3
  • intracellular bacteria such as mycobacteria, particularly those evoked through immunization with BCG.
  • the T cell antigen e.g. peptide
  • the T cell antigen may be derived from the tetanus toxoid such as P2, P4 or P30.
  • the T cell antigen e.g. peptide
  • the T cell antigen may be one that elicits an existing immune response in a subject that has been generated by prior vaccination against an infectious agent.
  • the subject may be vaccinated with a tetanus toxin, before being administered the agent of the invention comprising the relevant T cell antigen.
  • the T cell antigen is one which is found in a childhood vaccine.
  • the T cell antigen (eg peptide) may also be one that elicits an existing immune response in a subject that has been generated by exposing that subject's T cells to the antigen in vitro.
  • Peptides can be produced by well known chemical procedures, such as solution or solid-phase synthesis, or semi-synthesis in solution beginning with protein fragments coupled through conventional solution methods as is known in the art.
  • the peptide can be synthesised by established methods including recombinant methods.
  • the T cell antigen is a polypeptide or peptide
  • other antigens are also capable of eliciting immune responses and so have utility in the present invention.
  • ⁇ T cells do not recognise MHC-associated peptide antigens and are not MHC restricted.
  • Some ⁇ T cell clones recognise small phosphorylated molecules, pyrophosphorylated compounds (eg HMBPP (E-4-hydroxy-3-methyl-but-2-enyl-pyrophosphate) and IPP (isopentenyl pyrophosphate)), alkyl amines or lipids (e.g. phosphorylated lipids) that may be presented by ‘non-classical’ class I MHC-like molecules called CD1 molecules.
  • NK-T cells e.g. V ⁇ 24V ⁇ 11 cells
  • lipids e.g. ceramides such as ⁇ -gal-ceramide
  • the T cell antigen may be any of these molecules that are known to elicit a T cell response.
  • the T cell antigen may be an autoantigen or allergen respectively.
  • the immune response that is contributing to the disorder is redirected to unwanted cells so as to combat the disorder.
  • the T cell antigen may be chemically modified provided that it is still capable of eliciting a T cell response.
  • Such chemical modification may include, for instance, the addition of a metal such as nickel, since it has been shown that in certain allergic patients there are T cells which recognise a peptide with a bound nickel atom (Romagnoli et al 1991, EMBO J 10: 1303-1306).
  • the T cell antigen can also be modified by an organic molecule which enhances the immunogenicity (Romero et al 1993, J Immunol 150: 3825-3831).
  • the T cell antigen is a peptide
  • it may comprise naturally occurring amino acids encoded by DNA, and/or one or more non-natural amino acids, including amino acids in the “D” isomeric form, provided that it is recognised by the corresponding T cell.
  • the peptide may be a peptide ‘mimetic’ ie peptidomimetic which mimics the structural features of any of the peptides mentioned above.
  • the T cell antigen may be a retro-inverso peptide.
  • the T cell antigen when a peptide, may be a mimotope, ie a peptide composed of natural or non-natural amino acids that mimics the structure of the natural epitope. Mimotopes often stimulate T cells more potently.
  • the T cell antigens are substantially non-toxic in the absence of T lymphocytes.
  • substantially non-toxic we mean that the antigens have considerably lower or preferably no detectable toxicity, compared to toxins such as Pseudomonas exotoxin.
  • T cell antigens that may be used in the invention using the database available at www.immuneepitope.org (Vita R, Zarebski L, Greenbaum J A, Emami H, Hoof I, Salimi N, Damle R, Sette A, Peters B. The immune epitope database 2.0. Nucleic Acids Res. 2010 January; 38 (Database issue):D854-62. Epub 2009 Nov. 11).
  • T cell antigen is released from the targeting moiety by means of a cleavage site between the T cell antigen and targeting moiety being cleaved selectively in the vicinity of the unwanted cells.
  • cleavage site that is cleavable selectively in the vicinity of the unwanted cells we include the meaning of a site that can only be cleaved by a molecule which resides selectively in the vicinity of the unwanted cells, so as to release the T cell antigen from the targeting moiety.
  • the molecule that cleaves the cleavage site resides in the vicinity of the unwanted cells at a concentration at least five times or ten times higher than the concentration of the molecule outside the vicinity of the unwanted cells, and more preferably at a concentration at least 100 or 500 or 1000 times higher.
  • the molecule that cleaves the cleavage site is found only in the vicinity of the unwanted cells. For example, when the unwanted cells are particular tumour cells (e.g.
  • the cleavage site may be one that is cleaved by a molecule which resides selectively in the particular tumour (e.g. breast tumour) but which molecule does not reside outside the vicinity of the particular tumour (e.g. breast tumour).
  • the cleavage site is selectively cleaved outside of the unwanted cell, at or near its surface, so that the T cell antigen can be presented by the unwanted cell to T cells without needing to be internalised.
  • the cleavage site is selectively cleaved in the vicinity of the unwanted cells so that the T cell antigen is preferentially presented by unwanted cells rather than by wanted cells.
  • the cleavage site is one that is selectively cleaved such that the T cell antigen is released in the vicinity of (e.g. at or near to the cell surface) the unwanted cells at least five times or ten times more than the extent to which it is released in the vicinity of wanted cells, and more preferably at least 100 or 500 or 1000 times more.
  • the T cell antigen is not released in the vicinity of wanted cells, and therefore not presented by wanted cells.
  • the skilled person will be able to identify an appropriate cleavage site that is selectively cleavable in the vicinity of the unwanted cell, using established methods in the art. For example, which proteases cleave which peptides can be assessed by consulting peptide libraries and studying an MS analysis of the fragmentation profile following cleavage. Also, published literature of protease cleavage motifs and peptide cleavage data can be searched as described further below. Gene expression and proteomic data may also be analysed to identify which proteases are expressed by particular unwanted cells.
  • the T cell antigen is selectively released in the vicinity of the unwanted cells.
  • the inventors believe that this allows the unwanted cells to present the T cell antigen to T cells, thereby redirecting an existing immune response to the unwanted cells.
  • the cleavage site is one that is cleaved in the vicinity of the unwanted cells and outside the unwanted cells, for example at the cell surface.
  • the T cell antigen can be released in the vicinity of the external surface of the cell and presented to a T cell directly, without the need to be internalised and engage the appropriate processing pathways.
  • the invention includes an agent for preventing or treating a condition characterised by the presence of unwanted cells, the agent comprising (i) a targeting moiety that is capable of targeting to the unwanted cells; and (ii) a T cell antigen, wherein the T cell antigen can be released from the targeting moiety by selective cleavage of a cleavage site in the agent in the vicinity of and outside of the unwanted cells.
  • the T cell antigen is one which does not generate a new primary T cell response for that antigen, but rather elicits an existing T cell response in a subject.
  • the T cell antigen may be released inside the cell, without the need to undergo classical antigen processing, and still be presented to a T cell.
  • the cleavage site need not be cleaved at the surface of the cell but may be cleaved within the cell, for example via a receptor cycling pathway or in near-membrane compartments such as vesicles (e.g. pinocytic vesicles).
  • the cleavage site may be one that is cleavable by an enzyme such as any of a protease, a nuclease, a lipase, a lyase, a phosphatase or a carbohydrase, which may or may not be membrane bound.
  • an enzyme such as any of a protease, a nuclease, a lipase, a lyase, a phosphatase or a carbohydrase, which may or may not be membrane bound.
  • the cleavage site is a protease cleavage site.
  • the cleavage site may be cleavable selectively by proteases that reside in the vicinity of the tumour cells.
  • the protease cleavage site may be one that is cleavable by a tumour associated protease. It is well known that during tumour development, tumours aberrantly express proteases which allow them to invade local tissues and eventually metastasise.
  • the protease may include any of a cysteine protease (including the Cathepsin family B, L, S etc), an aspartyl protease (including Cathepsin D and E) and a serine protease (including Cathepsin A and G, Thrombin, Plasmin, Urokinase, Tissue Plasminogen Activator).
  • the protease may be a metalloproteinase (MMP1-28) including both membrane bound (MMP14-17 and MMP24-25) and secreted forms (MMP1-13 and MMP18-23 and MMP26-28).
  • the protease may belong to the A Disintegrin and Metalloproteinase (ADAM) and A Disintegrin, or Metalloproteinase with Thrombospondin Motifs (ADAMTS) families of proteases.
  • ADAM A Disintegrin and Metalloproteinase
  • ADAMTS Metalloproteinase with Thrombospondin Motifs
  • Other examples include CD10 (CALLA) and prostate specific antigen (PSA). It is appreciated that the proteases may or may not be membrane bound.
  • Protease cleavage sites are well known in the scientific literature, and linker sequences comprising such cleavage sites can be readily constructed using established genetic engineering techniques, or by synthetic synthesis techniques known in the art.
  • the protease cleavage site may be one that is cleavable by any of the proteases listed in Table 4 below, which indicates the expression of selected proteases in various tumour types.
  • Candidate substrates for the proteases are provided.
  • the skilled person will typically select a protease cleavage site that is selectively cleaved by a protease known to be highly expressed in that tumour type, as seen from the table.
  • Table 5 lists tumour sites in which ADAM protease overexpression has been reported, and so in an embodiment, the cleavage site is selectively cleavable by one of the ADAM proteases listed in Table 5. Accordingly, the agent may be used to prevent or treat the corresponding tumour type.
  • the cleavage site may be selectively cleavable by any of the following human proteases (MEROPS peptidase database number provided in parentheses; Rawlings N. D., Morton F. R., Kok, C. Y., Kong, J. & Barrett A. J. (2008) MEROPS : the peptidase database. Nucleic Acids Res.
  • pepsin A (MER000885), gastricsin (MER000894), memapsin-2 (MER005870), renin (MER000917), cathepsin D (MER000911), cathepsin E (MER000944), memapsin-1 (MER005534), napsin A (MER004981), Mername-AA034 peptidase (MER014038), pepsin A4 (MER037290), pepsin A5 ( Homo sapiens ) (MER037291), hCG1733572 ( Homo sapiens )-type putative peptidase (MER107386), napsin B pseudogene (MER004982), CYMP g.p.
  • ADAMTS7 peptidase (MER005894), ADAM30 peptidase (MER006268), ADAM21 peptidase ( Homo sapiens -type) (MER004726), ADAMTS10 peptidase (MER014331), ADAMTS12 peptidase (MER014337), ADAMTS13 peptidase (MER015450), ADAM33 peptidase (MER015143), ovastacin (MER029996), ADAMTS20 peptidase ( Homo sapiens -type) (MER026906), procollagen I N-peptidase (MER004985), ADAM2 protein (MER003090), ADAM6 protein (MER047044), ADAM7 protein (MER005109), ADAM18 protein (MER012230), ADAM32 protein (MER026938), non-peptidase homologue ( Homo sapiens chromosome 4) (MER029973), family M12 non-peptidase
  • chymopasin (MER001503), kallikrein-related peptidase 11 (MER004861), kallikrein-related peptidase 11 (MER216142), trypsin-2 type A (MER000021), HtrA1 peptidase ( Homo sapiens -type) (MER002577), HtrA2 peptidase (MER208413), HtrA2 peptidase (MER004093), HtrA3 peptidase (MER014795), HtrA4 peptidase (MER016351), Tysnd1 peptidase (MER050461), TMPRSS12 peptidase (MER017085), HAT-like putative peptidase 2 (MER021884), trypsin C (MER021898), kallikrein-related peptidase 7 (MER002001), matriptase (MER003735), kallikrein-related peptidase 13
  • taspase-1 (MER016969), gamma-glutamyltransferase 5 (mammalian-type) (MER001977), gamma-glutamyltransferase 1 (mammalian-type) (MER001629), gamma-glutamyltransferase 2 ( Homo sapiens ) (MER001976), gamma-glutamyltransferase-like protein 4 (MER002721).
  • gamma-glutamyltransferase-like protein 3 (MER016970). similar to gamma-glutamyltransferase 1 precursor ( Homo sapiens ) (MER026204).
  • gamma-glutamyltransferase 1 precursor Homo sapiens ) (MER026205). Mername-AA211 putative peptidase (MER026207). gamma-glutamyltransferase 6 (MER159283). gamma-glutamyl transpeptidase homologue (chromosome 2, Homo sapiens ) (MER037241). polycystin-1 (MER126824), KIAA1879 protein (MER159329). polycystic kidney disease 1-like 3 (MER172554). gamma-glutamyl hydrolase (MER002963). guanine 5′′-monophosphate synthetase (MER043387).
  • EGF-like module containing mucin-like hormone receptor-like 2 (MER037230). CD97 antigen (human type) (MER037286). EGF-like module containing mucin-like hormone receptor-like 3 (MER037288). EGF-like module containing mucin-like hormone receptor-like 1 (MER037278). EGF-like module containing mucin-like hormone receptor-like 4 (MER037294).
  • EGF LAG seven-pass G-type receptor 2 precursor Homo sapiens ) (MER045397), Gpr64 ( Mus musculus )-type protein (MER123205).
  • GPR56 Homo sapiens )-type protein (MER122057).
  • latrophilin 2 (MER122199).
  • latrophilin-1 (MER126380).
  • latrophilin 3 (MER124612).
  • protocadherin Flamingo 2 (MER124239).
  • ETL protein (MER126267).
  • G protein-coupled receptor 112 (MER126114). seven transmembrane helix receptor (MER125448).
  • Gpr114 protein (MER159320).
  • GPR126 vascular inducible G protein-coupled receptor (MER140015).
  • GPR125 Homo sapiens )-type protein (MER159279).
  • GPR116 Homo sapiens )-type G-protein coupled receptor (MER159280).
  • GPR128 Homo sapiens )-type G-protein coupled receptor (MER162015).
  • GPR133 Homo sapiens )-type protein (MER159334) GPR110 G-protein coupled receptor (MER159277), GPR97 protein (MER159322), KPG_006 protein (MER161773) KPG_008 protein (MER161835), KPG_009 protein (MER159335), unassigned homologue (MER166269), GPR113 protein (MER159352), brain-specific angiogenesis inhibitor 2 (MER159746), PIDD auto-processing protein unit 1 (MER020001), PIDD auto-processing protein unit 2 (MER063690), MUC1 self-cleaving mucin (MER074260), dystroglycan (MER054741), proprotein convertase 9 (MER022416), site-1 peptidase (MER001948), furin (MER000375), proprotein convertase 1 (MER000376), proprotein convertase 2 (MER000377), proprotein convertase 4 (MER028255), PACE4 proprotein convertase
  • Oncomine (www.oncomine.org) is an online cancer gene expression database, and so when the agent of the invention is for treating cancer, the skilled person may search the Oncomine database to identify a particular protease cleavage site that will be appropriate for treating a given cancer type.
  • Alternative databases include European Bioinformatic Institute (www.ebi.ac.uk) in particular (www.ebi.ac.uk/gxa).
  • Protease databases include PMAP (www.proteolysis.org), ExPASy Peptide Cutter (ca.expasy.org/tools/peptide cutter) and PMAP.Cut DB (cutdb.burnham.org).
  • peptides may be useful as linkers to join the T cell antigen to the targeting moiety as discussed below.
  • Colo205 express barley any ADAM18/27 ADAM19 ADAM20 ADAM21/31 ADAM22 ADAM23 ADAM28 ADAM29 ADAM30 ADAM33 ADAMTS1 ADAMTS2 ADAMTS3 ADAMTS4 ADAMTS5/11 ADAMTS6 ADAMTS7 ADAMTS8 ADAMTS9 ADAMTS10 ADAMTS12 ADAMTS13 ADAMTS14 ADAMTS15 ADAMTS16 ADAMTS17 ADAMTS18 ADAMTS19 ADAMTS20
  • proteolytic ADAMs a disintegrin and metalloproteinase
  • mRNA or protein levels have been found to be upregulated relative to normal tissue (adapted from Nature Reviews Cancer 8, 932-941 (December 2008)
  • the protease may be an esterase.
  • cleavage sites include linkages which are labile under certain conditions in the vicinity of unwanted cells (eg tumour microenvironment).
  • the cleavage site may comprise disulphide bonds, which can be reduced in the hypoxic tumour microenvironment, or may comprise pH sensitive moieties that break in acidic conditions. It will be understood, however, that the cleavage site must be selectively cleavable in the vicinity of the unwanted cells and so such linkages must be more labile and preferably only labile in the vicinity of unwanted cells compared to in the vicinity of wanted cells.
  • the cleavage site may comprise nucleic acid (eg DNA or RNA) that is selectively cleavable in the vicinity of unwanted cells (eg by nucleases).
  • nucleic acid eg DNA or RNA
  • Other cleavage sites include phosphate, lipid or disulphide containing moieties that may be cleavable by appropriate enzymes.
  • the T cell antigen is joined to the targeting moiety by a linker.
  • linker we include the meaning of a chemical moiety that attaches the targeting moiety to the T cell antigen, and which comprises a cleavage site that is cleavable selectively in the vicinity of the unwanted cells as described herein.
  • T cell antigen may either be bound covalently or non-covalently to the targeting moiety.
  • the T cell antigen is covalently attached to the targeting moiety.
  • the T cell antigen and targeting moiety are covalently attached by a linker.
  • the T cell antigen (e.g. peptide) and targeting moiety may be conveniently linked by any of the conventional ways of cross-linking molecules, such as those generally described in O'Sullivan et al Anal. Biochem . (1979) 100, 100-108, and as described in Example 2.
  • one of the T cell antigen e.g.
  • peptide) or targeting moiety may be enriched with thiol groups and the other reacted with a bifunctional agent capable of reacting with those thiol groups, for example the N-hydroxysuccinimide ester of iodoacetic acid (NHIA) or N-succinimidyl-3-(2-pyridyldithio)propionate (SPDP), a heterobifunctional cross-linking agent which incorporates a disulphide bridge between the conjugated species.
  • NHS iodoacetic acid
  • SPDP N-succinimidyl-3-(2-pyridyldithio)propionate
  • Amide and thioether bonds for example achieved with m-maleimidobenzoyl-N-hydroxysuccinimide ester, are generally more stable in vivo than disulphide bonds.
  • bis-maleimide reagents allow the attachment of a thiol group (e.g. thiol group of a cysteine residue of an antibody) to another thiol-containing moiety (e.g. thiol group of a T cell antigen or a linker intermediate), in a sequential or concurrent fashion.
  • thiol group e.g. thiol group of a cysteine residue of an antibody
  • thiol group of a T cell antigen or a linker intermediate e.g. thiol group of a T cell antigen or a linker intermediate
  • Other functional groups besides maleimide, which are reactive with a thiol group include iodoacetamide, bromoacetamide, vinyl pyridine, disulfide, pyridyl disulfide, isocyanate, and isothiocyanate.
  • cross-linking agents include S-acetylthioglycolic acid N-hydroxysuccinimide ester (SATA) which is a thiolating reagent for primary amines which allows deprotection of the sulphydryl group under mild conditions (Julian et al (1983) Anal. Biochem. 132, 68), dimethylsuberimidate dihydrochloride and N,N′-o-phenylenedimaleimide.
  • SATA S-acetylthioglycolic acid N-hydroxysuccinimide ester
  • crosslinking agents include sulfosuccinimidyl 4-[N-maleimidomethyl]cyclohexane-1-carboxylate (Sulfo-SMCC), sulfosuccinimidyl 6-(3′-[2-pyridyldithio]-propionamido) hexanoate (Sulfo-LC-SPDP) and N-[ ⁇ -Maleimidopropionic acid]hydrazide, trifluoroacetic acid salt (BMPH).
  • Sulfo-SMCC sulfosuccinimidyl 4-[N-maleimidomethyl]cyclohexane-1-carboxylate
  • Sulfo-LC-SPDP sulfosuccinimidyl 6-(3′-[2-pyridyldithio]-propionamido) hexanoate
  • BMPH trifluoroacetic acid salt
  • the T cell antigen and targeting moiety do not need to be cross-linked directly to each other, but may be attached via one or more spacer moieties.
  • the T cell antigen may be crosslinked to a chemical moiety which in turn is crosslinked to the targeting moiety.
  • a spacer moiety may comprise a cleavage site that is cleavable selectively in the vicinity of the unwanted cells, as discussed below. It will be appreciated that the spacer moiety may serve to prevent steric hindrance and facilitate protease cleavage.
  • Tables 6 and 7 provide examples of suitable T cell antigen peptides and how they may be incorporated into the agent of the invention.
  • the T cell antigen peptide may be joined to a protease cleavage site via a first spacer moiety, and the protease cleavage site in turn joined to a linker moiety via a second spacer moiety.
  • the linker may be used to attach the final peptide to the targeting moiety.
  • Tables 6 and 7 also list the proteases that cleave the corresponding protease cleavage sites.
  • peptides containing a T cell antigen and protease cleavage site that may be incorporated into the agent of the invention (e.g. by attachment to an appropriate targeting moiety such as an antibody) are listed in the table below.
  • the T cell antigen peptide is attached to the targeting moiety, either directly or indirectly through a spacer moiety, at its N-terminus.
  • FIG. 9B which lists three peptides that comprise a T cell epitope and a protease cleavage site.
  • Peptides (i) and (ii) have the T cell epitope at the N-terminus so that the epitope is attached to the targeting moiety via a spacer moiety (comprising a protease cleavage site and a cysteine coupling residue) joined to the C-terminus of the epitope.
  • peptide (iii) comprises the same T cell epitope but the epitope is attached to the targeting moiety via a spacer moiety (comprising a protease cleavage site and a cysteine coupling reside) joined to the N-terminus of the epitope.
  • the N-terminus of the T-cell epitope is further away from the targeting moiety (configuration: N terminus-(T cell epitope)-C-terminus-Targeting moiety), whereas in peptide (iii), the C-terminus of the T-cell epitope is further away from the targeting moiety (configuration: C-terminus-(T cell epitope)-N-terminus-Targeting moiety).
  • the configuration of peptide (iii) is the reverse of that of peptides (i) and (ii).
  • the configuration of peptide (iii) is preferred.
  • Table 7 provides examples of a suitable T cell antigen and how it may be incorporated into the agent of the invention such that the T cell antigen would be attached to the targeting moiety, either directly or indirectly through a spacer moiety at its N-terminus.
  • the invention provides an agent for preventing or treating a condition characterised by the presence of unwanted cells, the agent comprising (i) a targeting moiety that is capable of targeting to the unwanted cells; (ii) a T cell antigen; and (iii) a cleavable site between the targeting moiety and T cell antigen, wherein the cleavable site can be selectively cleaved in the vicinity of the unwanted cells.
  • the two components may be part of a fusion polypeptide that may be encoded by a nucleic acid molecule.
  • the invention includes such a nucleic acid molecule and host cells containing them.
  • an antibody targeting moiety may be genetically engineered to contain the T cell antigen using genetic engineering techniques well established in the art.
  • the T cell antigen may be embedded within the polypeptide sequence of the targeting moiety, provided that it can be released so as to be capable of being presented on an unwanted cell to elicit a T cell response.
  • the T cell antigen may reside within the polypeptide of the targeting moiety and be flanked by two cleavage sites which each may be selectively cleaved in the vicinity of the unwanted cell.
  • the T cell antigen may reside at one terminus of the targeting moiety and be released by virtue of one cleavage site being cleaved.
  • the T cell antigen and the targeting moiety are joined so that both portions retain their respective activities such that the agent may be targeted to an unwanted cell and the T cell antigen may be presented by the unwanted cell so as to elicit an immune response.
  • the T cell antigen and targeting moiety portions are typically joined by a linker peptide which comprises a cleavage site that is cleavable selectively in the vicinity of the unwanted cells as described below.
  • Suitable linker peptides are those that typically adopt a random coil conformation, for example the polypeptide may contain alanine or proline or a mixture of alanine plus proline residues.
  • the linker contains between 2 and 100 amino acid residues, more preferably between 2 and 50 and still more preferably between 4 and 20.
  • Polynucleotides which encode suitable targeting moieties are known in the art or can be readily designed from known sequences such as from sequences of proteins known to interact with surface markers expressed on unwanted cells or contained in nucleotide sequence databases such as the GenBank, EMBL and dbEST databases.
  • T cell antigens are known in the art or can readily be designed from known sequences and made.
  • polynucleotides which encode the agents used in the invention can readily be constructed using well known genetic engineering techniques.
  • final peptide we mean the peptide that is attached to the targeting moiety, for example by crosslinking via a cysteine thiol group Epitope Spacer 1 Cleavage Spacer2 Linker
  • Final Peptide Protease NLVPMVATV Q KWNKWALSR ASALASAL (SEQ C NLVPMVATVQKWNKWALSRASALASALC (SEQ ID No: (SEQ ID No: 282) (SEQ ID No: 283) 21) 281) NLVPMVATV Q HSSKLQL GGGSGGGGS C NLVPMVATVQHSSKLQLGGGSGGGGSC PSA (SEQ ID No: (SEQ ID No: (SEQ ID No: 284) (SEQ ID No: 285) 21) 266) NLVPMVATV Q GGGGF (SEQ GGGGFGGGGF C NLVPMVATVQGGGGFGGGGFGGGGFC Cathepsin B (SEQ ID No:
  • final peptide we mean the peptide that is attached to the targeting moiety, for example by crosslinking via a cysteine thiol group Linker Spacer 1 Cleavage Spacer 2 Epitope
  • Final Peptide Protease C SGGGGSGGGG CPGRVVGG A NLVPMVATV CSGGGGSGGGGCPGRVVGGANLVPMVATV uPa/tPA (SEQ ID No: (SEQ ID No: (SEQ ID No: (SEQ ID No: 297) 296) 254) 21) C SGGGGSGGGG GGR A NLVPMVATV CSGGGGSGGGGGGRANLVPMVATV (SEQ Plasmin/ (SEQ ID No: (SEQ ID No: ID No: 298) TMPRSS2 296) 21) C SGGGGSGGGG YLGRSYKV A NLVPMVATV CSGGGGSGGGGYLGRSYKVANLVPMVATV Cls
  • nucleic acid is then expressed in a suitable host to produce an agent of the invention.
  • nucleic acid encoding the agent of the invention may be used in accordance with known techniques, appropriately modified in view of the teachings contained herein, to construct an expression vector, which is then used to transform an appropriate host cell for the expression and production of the agent of the invention of the invention.
  • nucleic acid encoding the agent of the invention may be joined to a wide variety of other nucleic acid sequences for introduction into an appropriate host.
  • the companion nucleic acid will depend upon the nature of the host, the manner of the introduction of the nucleic acid into the host, and whether episomal maintenance or integration is desired, as is well known in the art.
  • the T cell antigen and targeting moiety are non-covalently attached.
  • immunological bindings or such binding as via biotin/avidin or streptavidin, respectively are preferred.
  • the targeting moiety may be a bispecific antibody, one specificity of which is directed to an entity expressed by the unwanted cell and one specificity of which is directed to the T cell antigen or part thereof.
  • the T cell antigen may contain further peptidic sequences which are recognised by the bispecific antibody.
  • T cell antigen Another possibility involves coupling the targeting moiety, for example to streptavidin whilst the T cell antigen is coupled to biotin, and vice versa.
  • Other means by which non-covalent interactions can be formed include leucine zipper sequences or affinity bonds.
  • cleavage site that is cleavable selectively in the vicinity of the unwanted cells, such that the T cell antigen can be released from the targeting moiety.
  • Amino acid residues described herein are generally in the natural “L” isomeric form. However, residues in the “D” isomeric form can be substituted for L-amino acid residues in certain situations, provided that the agent of the invention still retains its function, namely to prevent or treat a condition characterised by the presence of unwanted cells.
  • the definition also includes, unless otherwise specifically indicated, chemically-modified amino acids, including amino acid analogues (such as penicillamine, 3-mercapto-D-valine), naturally-occurring non-proteogenic amino acids (such as norleucine), beta-amino acids, azapeptides, N-methylated amino acids and chemically-synthesised compounds that have properties known in the art to be characteristic of an amino acid.
  • proteogenic indicates that the amino acid can be incorporated into a protein in a cell through well-known metabolic pathways.
  • the definition also includes amino acids in which the functional side group has been chemically derivatised.
  • derivatised molecules include, for example, those molecules in which free amino groups have been derivatised to form amine hydrochlorides, p-toluene sulfonyl groups, carbobenzoxy groups, t-butyloxycarbonyl groups, chloroacetyl groups or formyl groups.
  • Free carboxyl groups may be derivatised to form salts, methyl and ethyl esters or other types of esters or hydrazides.
  • Free hydroxyl groups may be derivatised to form O-acyl or O-alkyl derivatives.
  • derivatives are those peptide portions that contain one or more naturally occurring amino acid derivatives of the twenty standard amino acids.
  • the peptide portions of the agent of the invention can be peptide “mimetics”, i.e. peptidomimetics which mimic the structural features of peptides comprising or consisting of the amino acid sequence as described herein. Peptidomimetics can be even more advantageous in therapeutic use, in the resistance to degradation, in permeability or in possible oral administration.
  • a primary goal in the design of peptide mimetics has been to reduce the susceptibility of mimetics to cleavage and inactivation by peptidases.
  • one or more amide bonds have been replaced in an essentially isosteric manner by a variety of chemical functional groups.
  • This stepwise approach has met with some success in that active analogues have been obtained. In some instances, these analogues have been shown to possess longer biological half-lives than their naturally-occurring counterparts.
  • a variety of uncoded or modified amino acids such as D-amino acids and N-methyl amino acids have been used to modify mammalian peptides.
  • a presumed bioactive conformation has been stabilised by a covalent modification, such as cyclization or by incorporation of ⁇ -lactam or other types of bridges (Veber et al, 1978) and Thorsett et al, 1983).
  • a covalent modification such as cyclization or by incorporation of ⁇ -lactam or other types of bridges (Veber et al, 1978) and Thorsett et al, 1983).
  • Rich (1986) has been to design peptide mimics through the application of the transition state analogue concept in enzyme inhibitor design.
  • the secondary alcohol of statine mimics the tetrahedral transition state of the sessile amide bond of the pepsin substrate.
  • Other approaches include the use of azapeptides and beta-amino acids.
  • retro-inverso peptides also include the meaning of a peptide in which all of the L-amino acids are replaced with D-amino acids and the peptide bonds are reversed.
  • the peptides are composed of D-amino acids assembled in the reverse order from that of the parent L-sequence.
  • Retro-inverso peptides can be synthesised by methods known in the art, for example such as those described in Meziere et al (1997) J. Immunol. 159 3230-3237. This approach involves making pseudopeptides containing changes involving the backbone, and not the orientation of side chains which remain very similar to the parent peptide. Retro-inverse peptides are much more resistant to proteolysis.
  • any of the targeting moiety, T cell antigen, cleavage site, spacer moieties and targeting moiety as described herein are peptides or polypeptides
  • any one or more of those peptides or polypeptides may be substituted for a corresponding peptidomimetic that retains the respective activity of the parent peptide or polypeptide. This may help to confer protease resistance on the agent of the invention and thereby improve its stability.
  • a T cell antigen is attached to a targeting moiety via one or more peptide spacer moieties, it may be desirable for one or more of those spacer moieties to be peptidomimetics, e.g. wherein one or more of the naturally occurring amino acids of the spacer moieties are replaced or modified, for example, to improve stability.
  • stabilising groups include amido, acetyl, benzyl, phenyl, tosyl, alkoxycarbonyl, alkyl carbonyl, benzyloxycarbonyl and the like end group modifications. Additional modifications include using a “D” amino acid in place of a “L” amino acid at the termini, and amide rather than amino or carboxy termini or acetyl rather than amino termini, to inhibit exopeptidase activity.
  • the agent of the invention may have a capping moiety, preferably a moiety that is less than 200 Da in molecular weight.
  • Further capping moieties include a naftyl group or a polyethylene glycol group. It is appreciated that retro-inverso peptides are already relatively stable and so may not require additional capping moieties.
  • the agent of the invention has a half-life in plasma of at least 24 hours at 37° C.
  • agent of the invention may be modified so that it can be more easily detected, for example by biotinylating it or by incorporating any detectable label known in the art such as radiolabels, fluorescent labels or enzymatic labels.
  • a particular preferred embodiment of the invention provides an agent for preventing or treating cancer, the agent comprising:
  • a targeting moiety that is capable of targeting to the cancer
  • T cell peptide can be released from the targeting moiety by selective cleavage in the vicinity of the cancer.
  • the cancer may be any cancer such as breast cancer, ovarian cancer, endometrial cancer, cervical cancer, bladder cancer, renal cancer, melanoma, lung cancer, prostate cancer, testicular cancer, thyroid cancer, brain cancer, oesophageal cancer, gastric cancer, pancreatic cancer, colorectal cancer, liver cancer, leukaemia, myeloma, non-Hodgkin's lymphoma, Hodgkin's lymphoma, acute myeloid leukaemia, acute lymphoblastic leukaemia, chronic lymphoblastic leukaemia, lymphoproliferative disorder, myelodysplastic disorder, myeloproliferative disease and premalignant disease.
  • cancer such as breast cancer, ovarian cancer, endometrial cancer, cervical cancer, bladder cancer, renal cancer, melanoma, lung cancer, prostate cancer, testicular cancer, thyroid cancer, brain cancer, oesophageal cancer, gastric cancer, pancreatic cancer, colorectal cancer, liver cancer,
  • agents of the invention may be used to redirect existing immune responses to kill particular unwanted cells in a specific manner. Since any unwanted cell may be targeted in this way, the agents of the invention offer significant therapeutic potential.
  • a second aspect of the invention provides a method of preventing or treating a condition characterised by the presence of unwanted cells, the method comprising administering an agent according to the first aspect of the invention to a subject.
  • the method may involve identifying a subject who has a condition or who is at risk of developing a condition characterised by unwanted cells (eg cancer), administering the agent according to the first aspect of the invention to the subject, and monitoring the levels of the unwanted cells in the subject either by conducting tests to determine the number of unwanted cells or by monitoring the clinical symptoms of the subject. Depending on the results of the monitoring step, it may be necessary to administer more of the agent.
  • unwanted cells eg cancer
  • the invention includes an agent according to the first aspect of the invention for use in preventing or treating a condition characterised by the presence of unwanted cells.
  • the invention also includes the use of an agent according to the first aspect of the invention in the manufacture of a medicament for preventing or treating a condition characterised by the presence of unwanted cells.
  • the unwanted cells are tumour cells and the condition is a tumour.
  • preventing or treating a condition we include the meaning of reducing or alleviating symptoms in a patient (i.e. palliative use), preventing symptoms from worsening or progressing, treating the disorder (e.g. by inhibition or elimination of the causative agent), or prevention of the condition or disorder in a subject who is free therefrom.
  • the agents of the invention lend themselves to personalised medicine in the clinic whereby the most appropriate agent to be administered to the patient is determined, and either selected or prepared in the clinic.
  • any one of the following may be determined: (i) the MHC alleles of the subject, (ii) the cytotoxic T cell response of the subject to a T cell antigen and (iii) the expression profile of the unwanted cell with regards to a molecule which may be the target of the targeting moiety and/or an enzyme which is able to cleave the cleavage site in the agent of the invention.
  • the MHC alleles of a subject can be assessed by serological assays at the antigen level or by using DNA assays at the genetic level. Determining whether a given antigen stimulates a specific cytotoxic T cell response in a subject can be done by contacting isolated peripheral mononuclear blood cells from the subject with the antigen and using standard assays for cell proliferation. Assessing the expression profile of the unwanted cell may be carried out on a biopsy sample using routine assays for measuring nucleic acid (e.g. DNA or RNA transcripts) or protein levels. For example, transcriptomic or proteomic techniques may be used. In this way, it will be possible to identify tailored targeting moieties that bind specifically to, for example, surface markers expressed by the unwanted cell. It may also be possible to identify appropriate protease cleavage sites that may be selectively cleaved in the vicinity of the unwanted cells.
  • nucleic acid e.g. DNA or RNA transcripts
  • proteomic or proteomic techniques may be used. In this way,
  • the method of the second aspect of the invention may include the steps of (i) identifying a subject who has a condition, or who is at risk of developing a condition characterised by the presence of unwanted cells (eg cancer), (ii) taking a sample from the subject, (iii) analysing the sample to identify the optimum targeting moiety, T cell antigen and/or cleavage site for preventing or treating the condition in that subject, (iii) preparing the agent of the invention, (iv) administering the agent to the subject, and (v) monitoring the levels of unwanted cells in the subject either by conducting tests to determine the number of unwanted cells or by monitoring the clinical symptoms of the subject.
  • unwanted cells eg cancer
  • an apparatus may be used to select and optionally prepare the most appropriate agent to be used for a particular patient.
  • the apparatus may perform an automated analysis of one or more samples from the subject, and based on this analysis select and optionally prepare a tailor-made agent for that subject.
  • the apparatus may perform serological assays on the sample to determine a subject's MHC alleles and based on this test various peptides for their efficiency in eliciting cytotoxic T cell response, so as to identify the best T cell antigen for use in that patient.
  • the apparatus may carry out an expression profile of unwanted cells from the subject (eg from a biopsy sample) so as to determine a suitable targeting moiety that will bind to the unwanted cell and/or determine a suitable cleavage site that will be selectively cleaved in the vicinity of the unwanted cell.
  • the agent can contain a T cell antigen that is known to bind to patient's MHC molecules and elicit a strong T cell response, a targeting moiety that is known to bind selectively to surface markers expressed by the unwanted cell, and a protease cleavage site that allows the release of the T cell antigen in the vicinity of the unwanted cells.
  • the subject is administered a further therapeutic agent in addition to the agent according to the first aspect of the invention.
  • a further therapeutic agent known to be useful for combating that condition may be administered.
  • a further anti-cancer agent eg anti-neoplastic chemotherapy
  • the further therapeutic agent may be one that is known to have therapeutic application in allergic disease, inflammatory disease, regenerative medicine and neuroregenerative disease.
  • the further therapeutic agent may be administered at the same time as the agent of the invention (i.e. simultaneous administration optionally in a co-formulation) or at a different time to the agent of the invention (i.e. sequential administration).
  • the further therapeutic agent may be any one or more of a vaccine; an immuno stimulatory drug; an anti-cancer agent; an agent inhibiting an antibody response against the agent of the invention; and/or a protease inhibitor.
  • the subject in order to boost the effector immune response against the particular T cell antigen used, it may be desirable to vaccinate the subject with the T cell antigen; and/or administer immunostimulating agents such as IL-2, IL-7, IFN ⁇ , GM-CSF, metformin, lenalidomide; and/or administer anti-immunoregulatory agents such as Ipilimumab; all of which may be considered as further therapeutic agents.
  • immunostimulating agents such as IL-2, IL-7, IFN ⁇ , GM-CSF, metformin, lenalidomide
  • anti-immunoregulatory agents such as Ipilimumab
  • the subject may also be administered one or more agents that are known to inhibit the activity of B cells, such as any of Rituximab, cyclophosphamide, Syk inhibitors, an anti-BAFF antibody (eg Belimumab), an anti-CD22 antibody, an anti-CD20 antibody and an anti-CD19 antibody, all of which may be considered as further therapeutic agents.
  • agents that are known to inhibit the activity of B cells such as any of Rituximab, cyclophosphamide, Syk inhibitors, an anti-BAFF antibody (eg Belimumab), an anti-CD22 antibody, an anti-CD20 antibody and an anti-CD19 antibody, all of which may be considered as further therapeutic agents.
  • the inhibitor of B cells is administered to the subject prior to the agent of the invention, eg as a pre-treatment to ablate B cells.
  • a particular protease inhibitor so as to improve the target selectivity of the agent of the invention.
  • a targeting moiety is known to bind cells in both the heart and breast tissue, but only those in the breast are to be targeted, it may be desirable to administer an agent that selectively inhibits the protease responsible for releasing the T cell antigen, in the heart but not the breast.
  • an agent is administered to inhibit a protease that is capable of releasing the T cell antigen but which protease resides in the vicinity (eg at or near the surface of) of wanted cells but not in the vicinity (eg at or near the surface of) of unwanted cells.
  • a protease cleavage site of the agent of the invention is cleavable by multiple proteases, some of which reside in the vicinity of unwanted cells and some of which reside in the vicinity of wanted cells.
  • targeting specificity may be improved by administering a protease inhibitor that inhibits a protease that resides in the vicinity of wanted cells but nevertheless is capable of cleaving the cleavage site and therefore releasing the T cell antigen from the agent of the invention.
  • the effect of administering the inhibitor would be to ensure that the T cell antigen is preferentially released in the vicinity of the unwanted cells.
  • a subject with cancer also has active rheumatoid arthritis where MMP2 and other proteases are active, and the one or more cleavage sites in the agent of the invention are cleavable by multiple proteases including MMP2, it may be beneficial to inhibit MMP2 to prevent cleavage of the agent at the arthritic joint but retain cleavage at the cancer site by another protease.
  • the invention thus includes a composition comprising (i) an agent according to the first aspect of the invention and (ii) a further therapeutic agent, for use in preventing or treating a condition characterised by the presence of unwanted cells.
  • a composition comprising (i) an agent according to the first aspect of the invention and (ii) a further therapeutic agent, for use in preventing or treating a condition characterised by the presence of unwanted cells.
  • the agent of the invention and the further therapeutic agent may be administered simultaneously or sequentially
  • the invention includes an agent according to the first aspect of the invention for use in preventing or treating a condition characterised by the presence of unwanted cells in a subject who is administered a further therapeutic agent.
  • the invention includes a therapeutic agent for use in preventing or treating a condition characterised by the presence of unwanted cells in a subject who is administered an agent according to the first aspect of the invention.
  • the invention includes a use of a composition comprising (i) an agent according to the first aspect of the invention and (ii) a further therapeutic agent, in the manufacture of a medicament for preventing or treating a condition characterised by the presence of unwanted cells.
  • a composition comprising an agent according to the first aspect of the invention in the manufacture of a medicament for preventing or treating a condition characterised by the presence of unwanted cells in a subject who is administered a further therapeutic agent.
  • the invention includes the use of a therapeutic agent in the manufacture of a medicament for preventing or treating a condition characterised by the presence of unwanted cells in a subject who is administered an agent according to the first aspect of the invention.
  • the invention also provides a composition
  • a composition comprising (i) an agent according to the first aspect of the invention and (ii) a further therapeutic agent suitable for preventing or treating the same condition characterised by the presence of unwanted cells.
  • a further therapeutic agent suitable for preventing or treating the same condition characterised by the presence of unwanted cells.
  • the therapeutic agent mentioned in the immediately preceding two paragraphs may be agents suitable for treating the same condition characterised by the presence of unwanted cells, as treatable by the agents of the invention.
  • a third aspect of the invention provides an agent according to the first aspect of the invention for use in medicine.
  • a fourth aspect of the invention a pharmaceutical composition
  • a pharmaceutical composition comprising an agent according to the first aspect of the invention, and a pharmaceutically acceptable carrier, diluent or excipient.
  • the agent of the invention Whilst it is possible for the agent of the invention to be administered alone, it is preferable to present it as a pharmaceutical formulation, together with one or more acceptable carriers.
  • the carrier(s) must be “acceptable” in the sense of being compatible with the therapeutic agent and not deleterious to the recipients thereof.
  • the carriers will be water or saline which will be sterile and pyrogen free.
  • the formulations may conveniently be presented in unit dosage form and may be prepared by any of the methods well known in the art of pharmacy. Such methods include the step of bringing into association the active ingredient (agent for treating or preventing a condition characterised by unwanted cells) with the carrier which constitutes one or more accessory ingredients.
  • the formulations are prepared by uniformly and intimately bringing into association the active ingredient with liquid carriers or finely divided solid carriers or both, and then, if necessary, shaping the product.
  • Formulations in accordance with the present invention suitable for oral administration may be presented as discrete units such as capsules, cachets or tablets, each containing a predetermined amount of the active ingredient; as a powder or granules; as a solution or a suspension in an aqueous liquid or a non-aqueous liquid; or as an oil-in-water liquid emulsion or a water-in-oil liquid emulsion.
  • the active ingredient may also be presented as a bolus, electuary or paste.
  • a tablet may be made by compression or moulding, optionally with one or more accessory ingredients.
  • Compressed tablets may be prepared by compressing in a suitable machine the active ingredient in a free-flowing form such as a powder or granules, optionally mixed with a binder (e.g. povidone, gelatin, hydroxypropylmethyl cellulose), lubricant, inert diluent, preservative, disintegrant (e.g. sodium starch glycolate, cross-linked povidone, cross-linked sodium carboxymethyl cellulose), surface-active or dispersing agent.
  • Moulded tablets may be made by moulding in a suitable machine a mixture of the powdered compound moistened with an inert liquid diluent.
  • the tablets may optionally be coated or scored and may be formulated so as to provide slow or controlled release of the active ingredient therein using, for example, hydroxypropylmethylcellulose in varying proportions to provide desired release profile.
  • Formulations suitable for topical administration in the mouth include lozenges comprising the active ingredient in a flavoured basis, usually sucrose and acacia or tragacanth; pastilles comprising the active ingredient in an inert basis such as gelatin and glycerin, or sucrose and acacia; and mouth-washes comprising the active ingredient in a suitable liquid carrier.
  • Formulations suitable for parenteral administration include aqueous and non-aqueous sterile injection solutions which may contain anti-oxidants, buffers, bacteriostats and solutes which render the formulation isotonic with the blood of the intended recipient; and aqueous and non-aqueous sterile suspensions which may include suspending agents and thickening agents.
  • the formulations may be presented in unit-dose or multi-dose containers, for example sealed ampoules and vials, and may be stored in a freeze-dried (lyophilised) condition requiring only the addition of the sterile liquid carrier, for example water for injections, immediately prior to use.
  • Extemporaneous injection solutions and suspensions may be prepared from sterile powders, granules and tablets of the kind previously described.
  • the agent of the invention can be administered in the form of a suppository or pessary, or they may be applied topically in the form of a lotion, solution, cream, ointment or dusting powder.
  • the agent may also be transdermally administered, for example, by the use of a skin patch.
  • Preferred unit dosage formulations are those containing a daily dose or unit, daily sub-dose or an appropriate fraction thereof, of an active ingredient.
  • formulations of this invention may include other agents conventional in the art having regard to the type of formulation in question, for example those suitable for oral administration may include flavouring agents.
  • the amount of the agent which is administered to the individual is an amount effective to combat the particular individual's condition.
  • the amount may be determined by the physician.
  • the subject to be treated is a human.
  • the subject may be an animal, for example a domesticated animal (for example a dog or cat), laboratory animal (for example laboratory rodent, for example mouse, rat or rabbit) or an animal important in agriculture (i.e. livestock), for example horses, cattle, sheep or goats.
  • a domesticated animal for example a dog or cat
  • laboratory animal for example laboratory rodent, for example mouse, rat or rabbit
  • animal important in agriculture i.e. livestock
  • horses, cattle, sheep or goats for example horses, cattle, sheep or goats.
  • the invention provides a kit of parts for preventing or treating a condition characterised by the presence of unwanted cells, the kit comprising: (i) a targeting moiety that is capable of targeting to the unwanted cells and which is attached to a first binding partner, and (ii) a T cell antigen that is attached to a second binding partner which is capable of binding to the first binding partner, wherein the T cell antigen can be released from the second binding partner by selective cleavage of a cleavage site between the second binding partner and T cell antigen in the vicinity of the unwanted cells.
  • kits of parts are for preventing or treating cancer.
  • first and second binding partners we include the meaning of any two moieties which bind to each other selectively. Most preferably, the first and second binding partners only bind to each other and not to any other moieties. Non-covalent binding such as between biotin/avidin or streptavidin, or immunological bindings are preferred.
  • the first binding partner may be biotin and the second binding partner may be avidin, and vice versa.
  • the first binding partner may be an antigen and the second binding partner may be an antibody specific for that antigen, and vice versa.
  • any pair of first and second binding partners that selectively bind to each other may be used, and suitable pairs will be known to the skilled person.
  • the kit allows one to first administer the targeting moiety to the subject, and establish the correct localisation of the targeting moiety in the subject (for example by the targeting moiety being detectably labelled (eg radiolabelled)) before administering the T cell antigen.
  • the T cell antigen is then targeted to the unwanted cells by virtue of the second binding partner binding to the first binding partner. Once in the vicinity of the unwanted cells, the T cell antigen will be released from the second binding partner by selective cleavage of a cleavage site between the second binding partner and T cell antigen, allowing it to be presented on the surface of the unwanted cells so as to re-direct an existing immune response to the unwanted cells.
  • the invention further provides a method of preventing or treating a condition characterised by the presence of unwanted cells, the method comprising administering (i) a targeting moiety that is capable of targeting to the unwanted cells and which is attached to a first binding partner, and (ii) a T cell antigen that is attached to a second binding partner which is capable of binding to the first binding partner, wherein the T cell antigen can be released from the second binding partner by selective cleavage of a cleavage site between the second binding partner and T cell antigen in the vicinity of the unwanted cells, to the subject.
  • the targeting moiety is administered before the T cell antigen, for example to allow to correct localisation of the targeting moiety at the unwanted cells to be established.
  • the targeting moiety may be administered at the same time as the T cell antigen.
  • the invention provides a targeting moiety that is capable of targeting to unwanted cells and which is attached to a first binding partner, and a T cell antigen that is attached to a second binding partner which is capable of binding to the first binding partner, wherein the T cell antigen can be released from the second binding partner by selective cleavage of a cleavage site between the second binding partner and T cell antigen in the vicinity of the unwanted cells, for use in preventing or treating a condition characterised by unwanted cells in a subject.
  • the targeting moiety is administered before the T cell antigen, for example to allow to correct localisation of the targeting moiety at the unwanted cells to be established.
  • the targeting moiety may be administered at the same time as the T cell antigen. It is appreciated that the targeting moiety and T cell antigen may be attached to each other by binding of the first and second binding partners.
  • a further kit of parts provided by the invention comprises (i) a targeting moiety that is capable of targeting to unwanted cells, (ii) a T cell antigen, and (iii) one or more means or reagents to assess one or more of a subject's (a) MHC alleles, (b) cytotoxic T cell response to a T cell antigen and (c) expression profile of an unwanted cell in the subject.
  • kits of parts may be useful in tailoring a particular agent as defined in the first aspect of the invention for a given patient. Suitable means or reagents that can be used to assess a subject's (a) MHC alleles, (b) cytotoxic T cell response to a T cell antigen and (c) expression profile of an unwanted cell in the subject, are well known and widely available in the art.
  • the kit of parts comprises the agent of the first aspect of the invention and the kit may be used to determine whether that agent is suitable for a particular patient.
  • the invention also provides a molecule comprising (i) a T cell antigen and (ii) a cleavage site; wherein the cleavage site contains a linking moiety to allow the molecule to be attached to a targeting moiety which targeting moiety is capable of targeting to unwanted cells, and wherein the cleavage site can be selectively cleaved in the vicinity of the unwanted cells.
  • the molecule may represent the part of the agent of the first aspect of the invention, without the targeting moiety.
  • preferences for the T cell antigen, the cleavage site, how the cleavage site is attached to the targeting moiety (e.g. via a linker moiety comprising a thiol group such a cysteine residue), the targeting moiety and unwanted cells include all of those defined above with respect to the first aspect of the invention.
  • the molecule comprises those final peptides listed in Table 6 above, wherein the ‘epitope’ listed in Table 6 corresponds to the T cell antigen of the molecule, and wherein the ‘cleavage sequence’ listed in Table 6 corresponds to the cleavage site.
  • the molecule may comprise or consist of any of the peptides:
  • NLVPMVATVQKWNKWALSRASALASALC NLVPMVATVQKWNKWALSRASALASALC
  • SEQ ID No: 285 NLVPMVATVQHSSKLQLGGGSGGGGSC
  • SEQ ID No: 287 NLVPMVATVQGGGGFGGGGFGGGGFC
  • SEQ ID No: 288) NLVPMVATVQKQSRKFVPGGGSGGGGSC
  • SEQ ID No: 292 NLVPMVATVQGPQGIASQGGGSGGGGSC
  • SEQ ID No: 293 NLVPMVATVQPQGIAGQGGGSGGGGSC
  • SEQ ID No: 295) NLVPMVATVQVLKVLKVLKVLKGGGSGGGGSC.
  • the molecule comprises those final peptides listed in Table 7 above, wherein the ‘epitope’ listed in Table 7 corresponds to the T cell antigen of the molecule, and wherein the ‘cleavage site’ listed in Table 7 corresponds to the cleavage site.
  • the molecule may comprise or consist of any of the peptides:
  • the molecule comprises or consists of any of the following peptides:
  • the targeting moiety described herein is Cetuximab
  • the T cell antigen comprises NLVPMVATV (SEQ ID No: 21)
  • the cleavage site comprises a MMP14 cleavage sequence.
  • the targeting moiety described herein is Rituximab
  • the T cell antigen comprises DYSNTHSTRYV (SEQ ID No: 55)
  • the cleavage site comprises a MMP2 cleavage sequence.
  • the targeting moiety described herein is Rituximab
  • the T cell antigen is TPRVTGGGAM (SEQ ID No: 31)
  • the cleavage site comprises a MMP2 cleavage sequence.
  • the targeting moiety described herein is hP67.6 (Gemtuzumab parent antibody), the T cell antigen is TPRVTGGGAM (SEQ ID No: 31) and the cleavage site comprises a MMP2 cleavage sequence.
  • the targeting moiety described herein is Cetuximab
  • the T cell antigen comprises NLVPMVATV (SEQ ID No: 21)
  • the cleavage site comprises any of the following cleavage sequences: a uPa/tPa cleavage sequence (CPGR-VVGG) (SEQ ID No: 254), a Plasmin/TMPRSS2 cleavage sequence (GGR-X) (SEQ ID No: 256), a C1s cleavage (YLGR-SYKV) (SEQ ID No: 257), a MASP2 cleavage sequence (SLGR-KIQI) (SEQ ID No: 259), a thrombin cleavage sequence (LVPRGS) (SEQ ID No: 260), a trypsin cleavage sequence (XXXR-X) (SEQ ID No: 261), an elastase 2 cleavage sequence (AAPV-X) (SEQ ID No: 262),
  • MDA.MB.231 cells often used as a model for breast cancer, were transduced with the MMP14 gene to ensure expression of the MMP14 protein within the cell.
  • T cells cultured together with cells stained using Cetuximab alone and cetuximab conjugated with the mismatched HLA-peptide There was very little IFN- ⁇ release from T cells cultured together with cells stained using Cetuximab alone and cetuximab conjugated with the mismatched HLA-peptide.
  • T cells cultured with cells stained using cetuximab conjugated with the correct peptide but lacking the MMP14 cleavage site also produced very little IFN- ⁇ whereas T cells cultured with the cells stained using cetuximab conjugated with the correct peptide containing the MMP14 cleavage site produced a large amount of IFN- ⁇ .
  • B-lymphoblastoid cells B-LCL
  • an agent comprising Rituximab conjugated to a cytomegalovirus HLA Class-II restricted peptide DYSNTHSTRYV (SEQ ID No: 55) with and without a cleavage site.
  • CD4 + T cells resulted in the generation of a T cell response when the B-LCL cells were contacted with the agent that contained the cleavage site.
  • T cells were cultured with Rituximab conjugated with the HLA-mismatched peptide containing the protease cleavage site there was no IFN- ⁇ produced. The results are shown in FIG. 2 .
  • FIG. 3 A similar example showing stimulation of CD4 + T cells by Rituximab TPRVTGGGAM conjugate is shown in FIG. 3 .
  • An agent comprising Cetuximab that is attached to a peptide T cell antigen such as NLVPMVATV (SEQ ID No: 21), derived from a cytomegalovirus, via a linker comprising a PRSA-KELR (SEQ ID No: 321) protease cleavage site (cleavable by Matrix metalloproteinase 14 (MMP14)) is prepared.
  • the agent is formulated with a pharmaceutically acceptable excipient and administered to patient with an epithelial malignancy such as breast cancer.
  • the agent, Cetuximab is targeted to breast cancer cells and upon binding comes into contact with MMP14.
  • the cleavage of the protease cleavage site releases the T cell antigen, NLVPMVATV (SEQ ID No: 21), which subsequently binds to the HLA-A*0201 molecules on the surface of the breast cancer cell.
  • NLVPMVATV SEQ ID No: 21
  • the breast cancer cells expressing the T cell antigen is targeted by the host immune system for cytolysis by the effector CD8 T cells.
  • B-Cell Lymphoma eg Chronic Lymphocytic Leukaemia
  • An agent comprising Rituximab that is attached to a HLA class-II peptide T cell antigen such as DYSNTHSTRYV (SEQ ID No: 55), derived from a cytomegalovirus, via a linker comprising a TIPV-SLRS (SEQ ID No: 317) protease cleavage site (cleavable by Matrix metalloproteinase 2 (MMP2)) is prepared.
  • the agent is formulated with a pharmaceutically acceptable excipient and administered to patient with B cell lymphoma (eg chronic lymphocytic leukaemia).
  • B cell lymphoma eg chronic lymphocytic leukaemia.
  • the agent, Rituximab is targeted to B cells and upon binding comes into contact with a protease.
  • the subsequent cleavage of the protease cleavage site releases the T cell antigen, DYSNTHSTRYV (SEQ ID No: 55), which subsequently binds to the HLA-DR*0107 molecules on the surface of the B cell.
  • the B cells expressing the T cell antigen would then be targeted by the host immune system for cytolysis by the effector CD4 T cells.
  • An agent comprising Cetuximab that is attached to a peptide T cell antigen derived from a cytomegalovirus via a linker comprising a CPGR-VVGG (SEQ ID No: 254) protease cleavage site (cleavable by uPA) is prepared.
  • the agent is formulated with a pharmaceutically acceptable excipient and administered to a bowel cancer patient.
  • B Cell Lymphoma eg Chronic Lymphocytic Leukaemia (CLL)
  • An agent comprising Rituximab that is attached to a peptide T cell antigen derived from a cytomegalovirus via a linker comprising a PQG-IAGQ (SEQ ID No: 269) protease cleavage site (cleavable by MMP2) is prepared.
  • the agent is formulated with a pharmaceutically acceptable excipient and administered to a B cell lymphoma (eg CLL) cancer patient.
  • B-lymphoblastoid cells B-LCL
  • an agent comprising Rituximab conjugated to a cytomegalovirus peptide TPRVTGGGAM (SEQ ID No: 31) with and without a cleavage site.
  • TPRVTGGGAM cytomegalovirus peptide
  • T cells cultured together with cells stained using Rituximab conjugated with the mismatched HLA-peptide with or without the protease cleavage site (1 & 2).
  • T cells cultured with cells stained using Rituximab conjugated with the correct peptide but lacking the protease cleavage site also produced very little IFN- ⁇ (4) whereas T cells cultured with the cells stained using Rituximab conjugated with the correct peptide containing the protease cleavage site (3) produced a large amount of IFN- ⁇ .
  • B Cell Lymphoma eg Chronic Lymphocytic Leukaemia
  • An agent comprising Rituximab that is attached to a HLA class-I peptide T cell antigen such as TPRVTGGGAM (SEQ ID No: 31), derived from a cytomegalovirus, via a linker comprising a TIPV-SLRS (SEQ ID No: 317) protease cleavage site (cleavable by Matrix metalloproteinase 2 (MMP2)) is prepared.
  • the agent is formulated with a pharmaceutically acceptable excipient and administered to patients with B cell lymphoma (eg chronic lymphocytic leukaemia).
  • B cell lymphoma eg chronic lymphocytic leukaemia.
  • the agent, Rituximab is targeted to B cells and upon binding comes into contact with a protease.
  • TPRVTGGGAM T cell antigen
  • HLA-A2+ tumor cell lines THP-1 (acute monocytic leukemia cell line); A498 (renal cell carcinoma); MDA-MB-231 and MCF-7 (breast cell adenocarcinomas); NCI-H522 (non-small cell lung carcinoma); Ovcar-3 (ovarian adenocarcinoma); Colo205 and HCT-116 (colorectal carcinoma)
  • THP-1 acute monocytic leukemia cell line
  • A498 renal cell carcinoma
  • MDA-MB-231 and MCF-7 breast cell adenocarcinomas
  • NCI-H522 non-small cell lung carcinoma
  • Ovcar-3 ovarian adenocarcinoma
  • Colo205 and HCT-116 colonrectal carcinoma
  • Antibody-peptide epitope conjugates were generated, through covalently linking T cell epitope peptides with clinically available antibodies Cetuximab and Rituximab. Neither APEC in solution nor plate-bound were able to activate cognate T cells. Healthy CD20+ B cells bound Ritixumab-APEC (RPEC) but were unable to activate T cells in vitro. However, CD20+ lymphoma cell lines were able to be efficiently targeted by T cells when bound by RPEC in vitro through proteolytic release of bound peptide demonstrating differential tumor targeting ( FIG. 5 ).
  • FIGS. 7B and 7C demonstrate successful targeting of colorectal adenocarcinoma cell lines and pancreatic carcinoma cell lines using an anti-Muc1 antibody peptide conjugate.
  • FIG. 7D demonstrates successful targeting of T cells using a protein that contains a viral peptide sequence as part of its polypeptide chain.
  • a single chain fragment V (scFv) antibody-like construct was prepared, encoding a protease recognition domain and T cell epitope, and shown to efficiently target MDA-MB-231 cells in vitro.
  • FIG. 8A shows that the conjugates according to the invention may be used to selectively target cancer cells. Following labelling of lymphoblastoid cells or healthy B cells with Rituximab conjugated with viral peptide, there is no recognition of healthy B cells whereas there is recognition of lymphoblastoid cells only in the presence of the viral peptide that the T cells are specific for.
  • FIG. 8B demonstrates plasma and serum stability of conjugates according to the invention.
  • FIG. 10A demonstrates the mechanism of action of the Cetuximab-peptide complex occurring at the cell surface and not by way of internalisation of the whole complex.
  • chemical fixation of target cells By chemical fixation of target cells, internalisation of the complex is inhibited and a positive IFN- ⁇ response using fixed cells would demonstrate external processing of the APEC.
  • the results show that target cells chemically fixed demonstrate a similar ability to induce IFN- ⁇ production by T cells when they are incubated with Cetuximab-NLVPMVATV-Protease Cleavage as that seen when target cells have not been chemically fixed.
  • chemically fixed target cells cannot induce an IFN- ⁇ response when labelled with an irrelevant APEC (Cetuximab-VLEETSVML-Protease Cleavage) similar to that seen in untreated target cells.
  • FIG. 10B demonstrates the ability to use a peptide as a targeting moiety in place of an antibody.
  • Peptides which directly bind to either EGF receptor or Her2/neu receptor were synthesised containing a protease cleavage sequence and the viral epitope named receptor peptides (EGF-NLVPMVATV (NLVPMVATVAIPVSLRSAAAYCRDYDYDGRYFDCY) (SEQ ID No: 314) Ponde et al (2011) Bioorg Med Chem Lett, 21 or Her2-NLVPMVATV (NLVPMVATVAIPVSLRSAAAFCDGFYACYMDV) (SEQ ID No: 311) Park et al (2000) Nat Biotech 18).
  • Target cells labelled with either peptide were able to induce an IFN- ⁇ response from viral-specific CD8+ T cells similar to that seen when target cells were pulsed with exogenous viral peptide. When either receptor peptide is removed, the target cells were not recognised by the T cells.
  • FIG. 13 shows that antibody peptide epitope complexes (APEC) formed of anti-EGFR Cetuximab and peptides were able to re-target antigen specific T cells to target these malignant cell lines, but only when the peptide contained a protease cleavage site.
  • APEC antibody peptide epitope complexes
  • FIG. 14 shows that antigen specific T cells are at the tumour site and that other antibodies may be used in the approach (eg anti-MUC1 antibody SM3).
  • the figure also demonstrates selective targeting of malignant cells compared to healthy cells.
  • the anti-CD20 Rituximab APEC efficiently targets malignant lymphoma cells in vitro but spares healthy B cells derived from peripheral blood ( FIG. 14C ).
  • the figure also shows the applicability toward MHC Class-II restricted peptides using CD4+ cytotoxic T cells ( FIG. 14D ), and that the APEC approach does not require the antigen processing capacity of target cells ( FIG. 14E ) suggesting that peptide cleavage is occurring at the cell membrane.
  • a Xenograft model used NOG mice (NOD Rag2 ⁇ / ⁇ ⁇ c ⁇ / ⁇ ) (M. Ito et al., Blood 100, 3175 (2002)).
  • Tumour cell lines were grown using standard laboratory tissue culture techniques and injected subcutaneously into the mice.
  • Human T cells were cultured using standard techniques from healthy laboratory donors.
  • T cells, antibody, or APEC is injected into the intraperitoneal cavity.
  • Mice were injected with luciferin and growth and metastatic dissemination of the cells monitored using IVIS Spectrum (Caliper Lifesciences). Quantitation of outgrowth kinetics is determined and metastasis quantified by measuring luminescent signal from each organ at the experimental endpoint.

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